“State of the Art Techniques in Treating Peripheral Nerve Injury”

Background – Peripheral nerve injuries remain a major clinical concern as they often lead to chronic disability and significant health care expenditures. Despite advancements in microsurgical techniques to enhance nerve repair, biologic approaches are needed to augment nerve regeneration and improve functional outcomes after injury. Methods – Presented herein is a review of the current literature on state of the art techniques to enhance functional recovery for patients with nerve injury. Four categories are considered: (1) electroceuticals; (2) nerve guidance conduits; (3) fat grafting, and; (4) optogenetics. Significant study results are highlighted, focusing on histological and functional outcome measures. Results – This review documents the current state of the literature. Advancements in neuronal stimulation, tissue engineering, and cell-based therapies demonstrate promise with regards to augmenting nerve regeneration and appropriate rehabilitation. Conclusions – The future of treating peripheral nerve injury will include multimodality utilization of electroconductive conduits, fat grafting, neuronal stimulation, and optogenetics. Further clinical investigation is needed to confirm the efficacy of these technologies on peripheral nerve recovery in humans, and how best to implement this treatment for a diverse population of nerve-injured patients. Financial Disclosure Statement: The authors have no financial disclosures to report. Corresponding author: Stephen W.P. Kemp, Ph.D, Director, Neuromuscular Lab, Assistant Research Professor, University of Michigan, Section of Plastic Surgery, Department of Biomedical Engineering, 1150 W Medical Center Drive, MSRB II, A570, Ann Arbor, MI, 48109-5456, P: (734) 615-2598; F: (734) 615-3292, swpkemp@med.umich.edu ©2017American Society of Plastic Surgeons