Designing Next-Generation Biomaterials to Enhance Peripheral Nerve Repair and Reconstruction

Peripheral nerve injuries are a common and potentially devastating condition affecting over 20 million people in the United States alone, resulting in significant functional disability and chronic pain for patients. Unfortunately, even when repaired under optimal conditions with cutting-edge techniques, current approaches to peripheral nerve repair result in incomplete functional recovery and chronic pain in over half of patients, highlighting the pressing need for the development of new strategies for peripheral nerve repair. Biomaterials, due to their tunable properties, can be rationally designed to address many aspects of peripheral nerve repair, making them a promising solution for improving functional outcomes following nerve repair. This review discusses the current lack of efficacious treatments for peripheral nerve repair and how biomaterials can fill this crucial void, as well as what properties those materials should have from a material, biological, and practical concerns perspective. The review is divided into three main sections, the first of which outlines the complex process of peripheral nerve repair, providing an understandable and clinically germane overview of peripheral nerve repair. Part two of this review discusses biological design principles to engineer biomaterials that favor nerve regeneration. Part three discusses practical considerations for adapting biomaterials for clinical use.