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Evaluation of Processed Nerve Allograft in Peripheral Nerve Surgery: A Systematic Review and Critical Appraisal
Skane Univ Hosp, Sweden; Lund Univ, Sweden.
Skane Univ Hosp, Sweden.
Skane Univ Hosp, Sweden.
Skane Univ Hosp, Sweden; Skane Univ Hosp, Sweden.
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2023 (English)In: Plastic and Reconstructive Surgery - Global Open, E-ISSN 2169-7574, Vol. 11, no 6, article id e5088Article in journal (Refereed) Published
Abstract [en]

Background:Peripheral nerve injuries cause substantial problems when not treated properly. A specific problem is reconstruction of nerve defects, which can be treated in different ways. This study aimed to systematically review whether processed nerve allograft (PNA) is justified in reconstruction of a nerve defect in patients after posttraumatic or iatrogenic peripheral nerve injury and to compare PNA with other established methods. Methods:A systematic review with a focused question, PICO (patient, intervention, comparison, outcome) and constraints, was performed. A structured literature search, including several databases, was done to evaluate the existing evidence for outcomes and postoperative complications related to PNA. The certainty of evidence was classified according to Grading of Recommendations, Assessment, Development and Evaluations. Results:No conclusions, concerning differences in outcome of nerve reconstruction using PNA compared with the use of nerve autograft or conduits, could be drawn. The level of certainty for all evaluated outcomes was very low (& OPLUS;◯◯◯). Most published studies lack a control group to patients treated with PNA; being only descriptive, making it difficult to compare PNA with established methods without substantial risk of bias. For studies including a control group, the scientific evidence was of very low certainty, due to a low number of included patients, and large, undefined loss of patients during follow-up, rendering a high risk of bias. Finally, the authors often had financial disclosures. Conclusion:Properly conducted randomized controlled trial studies on the use of PNA in reconstruction of peripheral nerve injuries are needed to establish recommendations in clinical practice.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS , 2023. Vol. 11, no 6, article id e5088
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-196863DOI: 10.1097/GOX.0000000000005088ISI: 001020251900001PubMedID: 37383478OAI: oai:DiVA.org:liu-196863DiVA, id: diva2:1792654
Conference
Scandinavian Society for Surgery of the Hand (SSSH), Malmo, SWEDEN, aug 24-26, 2022
Available from: 2023-08-30 Created: 2023-08-30 Last updated: 2024-01-29

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Dahlin, Lars
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health Sciences
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