Multiscale biomimetic design for peripheral nerve repair: Beyond passive bridging

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Neuroscience

Background:

• Peripheral nerve injuries, especially long-gap and complex ones, present significant clinical challenges with suboptimal outcomes from current surgical interventions.
• Existing nerve guidance conduits (NGCs) are passive and fail to replicate the native nerve's complex structure, microenvironment, or repair timing.

Purpose of the Study:

• To redefine biomimetic peripheral nerve repair by shifting from passive bridging to biologically instructed, adaptive neural interfaces.
• To systematically examine how different biomimicry strategies (structural, functional, spatiotemporal, cross-species) can be integrated into NGCs.
• To establish a design logic for advanced NGCs that are manufacturable and clinically translatable.

Main Methods:

• Bibliometric and meta-analytic evidence synthesis to inform the review.
• Systematic examination of biomimicry principles and their functional mandates in NGC design.
• Analysis of cue convergence, competition, and synergy within composite conduits.

Main Results:

• A redefined framework for biomimetic peripheral nerve repair, emphasizing adaptive neural interfaces.
• Specific functional mandates for structural, functional, spatiotemporal, and cross-species biomimicry.
• Consideration of manufacturability, sterilization, regulatory feasibility, and validation for long gaps.

Conclusions:

• Next-generation NGCs must evolve from static scaffolds to adaptive, biologically instructed interfaces.
• A prioritized design logic is crucial for developing manufacturable and clinically translatable NGCs.
• Biomimetic strategies, when orchestrated, hold the key to significantly improving peripheral nerve regeneration outcomes.