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Nerveregeneration after Reconstruction with Processed Human, Decellularized Allografts – First German Experiences in the Use of the Avance® Nerve Graft
Kristian Weissenberg, MD1; Eirini Liodaki, MD2; Catharina Elisabeth Strauss, MD1; Felix Stang, MD2; Peter Mailänder, MD, PhD2; Frank Siemers, MD, PhD1
1Bergmannstrost Trauma Center, Halle (Saale), Germany; 2Universityhospital of Schleswig-Holstein, Luebeck, Germany

Introduction: Peripheral nerve injuries occur very often in traumatic injury. In cases in which direct, tension-free repair is not possible, processed human allografts promise good results in nerveregeneration. The morbidities in the donor side such as sensory loss, neuroma formation or prolonged operation time while using an autograft are not seen. Since November 2013 nerve allografts have been available in Germany.

Materials & Methods: In two German hand surgery departments 15 reconstructions of peripheral nerves were performed with Avance® nerve graft (Axo Gen, Inc., Fl) by four experienced handsurgeons for different indications until June 2015. In two cases the median nerve was reconstructed up to a defect length of 7 cm. 13 digital nerves were repaired with an allograft. The static and moving 2PD, Semmes-Weinstein Monofilament Testing and in two cases nerve conduction velocity were mesured. The follow-ups were performed 6-12 months after surgery depending on the expected axon regeneration time.

Results: During this conference the first German experiences in the use of the Avance® Nerve Graft will be presented. Overall meaningful recovery for all repairs was reported in over 85%. All patients with defect length up to 5 cm reported sensory improvement. No signs of rejection or infection were reported.

Conclusions: The processed nerve allografts seem to be safe and effective in sensory improvement up to a defect length of 5 cm. A sufficient sample size to perform a comparative analysis is still lacking. The outcomes so far represent actual results from literature. More clinical data need to be collected

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