Closing the Gap: Bridging Peripheral Sensory Nerve Defects with a Chitosan-Based Conduit a Randomized Prospective...

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Neurosurgery

Background:

• Autologous nerve grafts are the gold standard for peripheral nerve repair.
• Nerve conduits offer a potential alternative but have yet to surpass graft efficacy.
• Chitosan demonstrates promising biocompatibility and stability for neural applications.

Purpose of the Study:

• To evaluate the efficacy of chitosan-based nerve conduits for sensory nerve regeneration in hand defects.
• To compare chitosan conduits against autologous nerve grafts in a prospective randomized clinical trial.

Main Methods:

• Forty-seven patients with peripheral nerve defects (up to 26 mm) were randomized to receive either a chitosan conduit or an autologous nerve graft.
• Outcomes assessed at 12 months included two-point discrimination, Semmes Weinstein Monofilament Testing, pain, and patient satisfaction.

Main Results:

• Chitosan conduits showed significant improvement in static two-point discrimination at six months (10.7 ± 1.2 mm), with comparable 12-month results to autologous grafts.
• Both groups demonstrated similar improvements in Semmes Weinstein testing and patient-reported outcomes (pain, satisfaction).
• One patient in the chitosan group required revision surgery due to complications.

Conclusions:

• Chitosan-based nerve conduits are safe and effective for bridging peripheral nerve lesions up to 26 mm in the hand.
• Functional outcomes with chitosan conduits are comparable to autologous nerve grafts.
• Chitosan represents a viable substitute for autologous nerve grafts in treating small hand nerve defects.