Back to 2026 ePosters
Early Experience of Using a Novel Hydrogel for Treatment and Prevention of Symptomatic Neuromas in the Upper Extremity
Ethan Y Song, MD
1, Patryk Ostrowski, Medical Student
2, Edward Kobraei, MD
3, Suhail K. Mithani, MD
1; Neill Y. Li, MD
1(1)Duke University Medical Center, Durham, NC, (2)Jagiellonian University Medical College, Kraków, Ma?opolska, Poland, (3)Kaiser Permanente ART Microsurgery and Nerve Center, San Jose, CA
IntroductionSymptomatic neuromas remain a pervasive clinical problem without a definitive treatment strategy despite having a multitude of available modalities. Nerve capping is an emerging surgical technique that aims to prevent and treat symptomatic neuromas. This study aims to assess early experience and short-term outcomes of a novel hydrogel-based nerve cap in prevention and treatment of symptomatic neuromas of the upper extremity.
Materials/MethodsA multicenter retrospective study was conducted to evaluate the efficacy of a novel hydrogel nerve cap (allay ™ Nerve Cap, Tulavi Therapeutics) for both prophylaxis and treatment of symptomatic neuromas. The hydrogel polymer was applied at the time of surgery by placing the cut end of the nerve in a silicone mold into which was injected the viscous hydrogel. The mold was withdrawn after 10 seconds. Outcomes evaluated included recurrence of symptomatic neuroma, development of a symptomatic neuroma in prophylactic cases, wound healing complications, and infection. Descriptive analysis was performed with R.
ResultsHydrogel nerve caps were used in 14 surgical cases in a total of 11 nerves in 13 patients with a follow up range of 1 to 9 months (median 6 months). Nerve caps were used in 17 nerves for prophylactic neuroma formation and therapeutically in 11 nerves for symptomatic neuromas (
Table 1). One patient was a smoker and another had diabetes. Patients did not endorse formation or return of neuropathic symptoms following surgery further highlighted through negative Tinel's sign at the site of intervention. VAS scores for symptomatic neuromas improved from 8.6 to 2.6 postoperatively. Three patients had delayed wound healing, one of which had exposed nerve gel requiring operative debridement. Continued study is ongoing to analyze long term outcomes of symptomatic neuroma formation utilizing this novel hydrogel and assess for durability of prevention of symptomatic neuroma.
ConclusionsProphylaxis and treatment of symptomatic neuromas assumes a wide variety of interventions with varying levels of consistency as well as long-term pain relief. The institution of novel hydrogel nerve caps appears to offer an effective method to prevent and treat symptomatic neuromas in the short-term. Ongoing long-term follow will help determine reliability of nerve caps alongside their use to regenerative peripheral nerve interfaces or implantation into bone, muscle, and fat.
Back to 2026 ePosters
