{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T14:04:14Z","timestamp":1774188254004,"version":"3.50.1"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"05","funder":[{"DOI":"10.13039\/100001765","name":"Musculoskeletal Transplant Foundation","doi-asserted-by":"crossref","award":["#2014-06351"],"award-info":[{"award-number":["#2014-06351"]}],"id":[{"id":"10.13039\/100001765","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Reconstr Microsurg"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Different types of nerve conduits are used to bridge peripheral nerve gaps when a tension-free repair is unattainable. To best support nerve regeneration, naturally occurring conduits have been tested. Since allografts offer an unlimited source of epineurium, we have developed human epineural conduit (hEC) as a novel technology to bridge nerve gaps. Considering acellular properties, and lack of immunogenic response, epineurium-derived conduits represent an attractive material, when compared with nerve allografts that require systemic immunosuppression. In this study, we introduce the hEC as a novel naturally occurring material applied for repair of nerve gaps after trauma.<\/jats:p><jats:p>\n          Methods\u2003We tested the application of hEC created from human sciatic nerve in the restoration of 20\u2009mm sciatic nerve defects in the nude rat model. Four experimental groups were studied: group 1: no repair control (n\u2009=\u20096), group 2: autograft control (n\u2009=\u20096), group 3: matched diameter hEC (n\u2009=\u20096), and group 4: large diameter hEC (n\u2009=\u20096). Functional tests of toe-spread and pin prick were performed at 1, 3, 6, 9, 12 weeks after repair. At 12 weeks, nerve samples were collected for immunostaining of Laminin B, S-100, glial fibrillary acidic protein (GFAP), nerve growth factor (NGF), vascular endothelial growth factor (VEGF), von Willebrand factor, and histomorphometric analysis of myelin thickness, axonal density, fiber diameter, and percentage of the myelinated nerve fibers. Muscle samples were gathered for gastrocnemius muscle index (GMI) and muscle fiber area ratio measurements.<\/jats:p><jats:p>\n          Results\u2003Best functional recovery, as well as GMI, was revealed for the autograft group, and was comparable to the matched hEC group. Significant differences were revealed between matched and large hEC groups in expression of S100 (p\u2009=\u20090.0423), NGF (p\u2009=\u20090.269), VEGF (p\u2009=\u20090.0003) as well as in percentage of myelinated fibers (p\u2009&lt;\u20090.001) and axonal density (p\u2009=\u20090.0003).<\/jats:p><jats:p>\n          Conclusion\u2003We established the feasibility of hEC creation. The innovative method introduces an alternative technique to autograft repair of nerve defects.<\/jats:p>","DOI":"10.1055\/s-0042-1758182","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:28:27Z","timestamp":1668558507000},"page":"392-404","source":"Crossref","is-referenced-by-count":4,"title":["Assessment of Human Epineural Conduit of Different Size Diameters on Efficacy of Nerve Regeneration and Functional Outcomes"],"prefix":"10.1055","volume":"39","author":[{"given":"Marcin Michal","family":"Strojny","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, United States"},{"name":"Department of Surgery, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0542-9960","authenticated-orcid":false,"given":"Katarzyna","family":"Kozlowska","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, United States"},{"name":"Department of Surgery, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0546-0060","authenticated-orcid":false,"given":"Sonia","family":"Brodowska","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5911-9629","authenticated-orcid":false,"given":"Klaudia","family":"R\u00f3\u017cczka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, United States"},{"name":"Department of Surgery, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6372-6122","authenticated-orcid":false,"given":"Maria","family":"Siemionow","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, United States"},{"name":"Department of Surgery, Poznan University of Medical Sciences, Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,11,15]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1177\/1753193408091349","article-title":"The early history of tubulation in nerve repair","volume":"33","author":"F F IJpma","year":"2008","journal-title":"J Hand Surg Eur Vol"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.injury.2010.12.030","article-title":"FDA approved guidance conduits and wraps for peripheral nerve injury: a review of materials and efficacy","volume":"43","author":"S Kehoe","year":"2012","journal-title":"Injury"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.expneurol.2009.03.031","article-title":"Management of nerve gaps: autografts, allografts, nerve transfers, and end-to-side neurorrhaphy","volume":"223","author":"W Z Ray","year":"2010","journal-title":"Exp Neurol"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/SAP.0b013e318223c2db","article-title":"Peripheral nerve defect repair with epineural tubes supported with bone marrow stromal cells: a preliminary report","volume":"67","author":"M Siemionow","year":"2011","journal-title":"Ann Plast Surg"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1002\/micr.30393","article-title":"Application of epineural sheath conduit for restoration of 6-cm long nerve defects in a sheep median nerve model","volume":"39","author":"M Siemionow","year":"2019","journal-title":"Microsurgery"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1097\/SAP.0b013e3181fd6b18","article-title":"Repair of peripheral nerve defects with epineural sheath grafts","volume":"65","author":"M Siemionow","year":"2010","journal-title":"Ann Plast Surg"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1007\/s12015-021-10301-z","article-title":"Application of human epineural conduit supported with human mesenchymal stem cells as a novel therapy for enhancement of nerve gap regeneration","volume":"18","author":"M Siemionow","year":"2022","journal-title":"Stem Cell Rev Rep"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1097\/00000637-200204000-00010","article-title":"Turnover epineural sheath tube in primary repair of peripheral nerves","volume":"48","author":"R Yavuzer","year":"2002","journal-title":"Ann Plast Surg"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1097\/00000637-200210000-00011","article-title":"Conventional versus epineural sleeve neurorrhaphy technique: functional and histomorphometric analysis","volume":"49","author":"C Tetik","year":"2002","journal-title":"Ann Plast Surg"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1002\/micr.20472","article-title":"The epineural sleeve technique for nerve graft reconstruction enhances nerve recovery","volume":"28","author":"P Lubiatowski","year":"2008","journal-title":"Microsurgery"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1097\/SAP.0000000000001117","article-title":"Epineural sheath jacket as a new surgical technique for neuroma prevention in the rat sciatic nerve model","volume":"79","author":"M Siemionow","year":"2017","journal-title":"Ann Plast Surg"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1097\/SAP.0000000000001176","article-title":"Application of epineural sheath as a novel approach for fat volume maintenance","volume":"79","author":"M Siemionow","year":"2017","journal-title":"Ann Plast Surg"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/00006534-197508000-00008","article-title":"The nerve gap: suture under tension vs. graft","volume":"56","author":"J Terzis","year":"1975","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/S0736-0266(01)00104-8","article-title":"An in vivo study of peripheral nerves in continuity: biomechanical and physiological responses to elongation","volume":"20","author":"P J Driscoll","year":"2002","journal-title":"J Orthop Res"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1732432","article-title":"Comparison of collagen and human amniotic membrane nerve wraps and conduits for peripheral nerve repair in preclinical models: a systematic review of the literature","volume":"\u2022\u2022\u2022","author":"E M Wolfe","year":"2022","journal-title":"J Reconstr Microsurg"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/S0363-5023(82)80107-X","article-title":"Nerve regeneration across an extended gap: a neurobiological view of nerve repair and the possible involvement of neuronotrophic factors","volume":"7","author":"G Lundborg","year":"1982","journal-title":"J Hand Surg Am"},{"issue":"02","key":"ref17","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1002\/micr.1920100213","article-title":"Complications from silicon-polymer intubulation of nerves","volume":"10","author":"M Merle","year":"1989","journal-title":"Microsurgery"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"863969","DOI":"10.3389\/fbioe.2022.863969","article-title":"Implantable biomaterials for peripheral nerve regeneration-technology trends and translational tribulations","volume":"10","author":"A Sanchez Rezza","year":"2022","journal-title":"Front Bioeng Biotechnol"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1097\/00006534-199003000-00015","article-title":"Clinical nerve reconstruction with a bioabsorbable polyglycolic acid tube","volume":"85","author":"S E Mackinnon","year":"1990","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1055\/s-2007-1006810","article-title":"A study of nerve regeneration across synthetic (Maxon) and biologic (collagen) nerve conduits for nerve gaps up to 5\u2009cm in the primate","volume":"6","author":"S E Mackinnon","year":"1990","journal-title":"J Reconstr Microsurg"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1055\/s-2002-19889","article-title":"Clinical use of nerve conduits in peripheral-nerve repair: review of the literature","volume":"18","author":"M F Meek","year":"2002","journal-title":"J Reconstr Microsurg"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1097\/SAP.0b013e31804d441c","article-title":"US Food and Drug Administration\/Conformit Europe-approved absorbable nerve conduits for clinical repair of peripheral and cranial nerves","volume":"60","author":"M F Meek","year":"2008","journal-title":"Ann Plast Surg"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"5","DOI":"10.4103\/ijps.IJPS_14_17","article-title":"The neurochemistry of peripheral nerve regeneration","volume":"50","author":"A Benga","year":"2017","journal-title":"Indian J Plast Surg"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1007\/s10354-018-0675-6","article-title":"Nerve grafting for peripheral nerve injuries with extended defect sizes","volume":"169","author":"T Kornfeld","year":"2019","journal-title":"Wien Med Wochenschr"},{"issue":"11","key":"ref25","doi-asserted-by":"crossref","first-page":"2340","DOI":"10.1016\/j.jhsa.2012.08.028","article-title":"Functional outcome following nerve repair in the upper extremity using processed nerve allograft","volume":"37","author":"M S Cho","year":"2012","journal-title":"J Hand Surg Am"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"698256","DOI":"10.1155\/2014\/698256","article-title":"Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies","volume":"2014","author":"D Grinsell","year":"2014","journal-title":"BioMed Res Int"},{"issue":"01","key":"ref27","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.jhsa.2010.10.013","article-title":"Technical use of synthetic conduits for nerve repair","volume":"36","author":"S E Mackinnon","year":"2011","journal-title":"J Hand Surg Am"},{"issue":"05","key":"ref28","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1097\/SAP.0000000000000060","article-title":"Minced nerve tissue in vein grafts used as conduits in rat tibial nerves","volume":"73","author":"C Sahin","year":"2014","journal-title":"Ann Plast Surg"},{"issue":"11","key":"ref29","first-page":"1197","article-title":"Assessment of immunologic, proangiogenic and neurogenic properties of human peripheral nerve epineurium for potential clinical application","volume":"32","author":"A Klimczak","year":"2017","journal-title":"Histol Histopathol"},{"issue":"08","key":"ref30","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/micr.22312","article-title":"The influence of nerve conduits diameter in motor nerve recovery after segmental nerve repair","volume":"34","author":"G Giusti","year":"2014","journal-title":"Microsurgery"},{"issue":"09","key":"ref31","doi-asserted-by":"crossref","first-page":"2194","DOI":"10.2106\/JBJS.H.01301","article-title":"Treatment of a segmental nerve defect in the rat with use of bioabsorbable synthetic nerve conduits: a comparison of commercially available conduits","volume":"91","author":"R H Shin","year":"2009","journal-title":"J Bone Joint Surg Am"},{"issue":"08","key":"ref32","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1089\/ten.tea.2008.0338","article-title":"Collagen nerve conduits promote enhanced axonal regeneration, schwann cell association, and neovascularization compared to silicone conduits","volume":"15","author":"S W Kemp","year":"2009","journal-title":"Tissue Eng Part A"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1007\/s11552-008-9158-3","article-title":"Limitations of conduits in peripheral nerve repairs","volume":"4","author":"A M Moore","year":"2009","journal-title":"Hand (N Y)"}],"container-title":["Journal of Reconstructive Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1758182.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T23:15:41Z","timestamp":1684192541000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1758182"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,15]]},"references-count":33,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2023,5,15]]},"published-print":{"date-parts":[[2023,6]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1758182","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0743-684X","1098-8947"],"issn-type":[{"value":"0743-684X","type":"print"},{"value":"1098-8947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,15]]}}}