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Amniotic Membrane Derived Products for Peripheral Nerve Repair
Dzana Katana, PhD; Yusuf Surucu, MD; Bahaa Shaaban, MD; David Guerrero, BS; Baris F. Bengur, MD, Kacey G. Marra, PhD
University of Pittsburgh
2023-02-10
Presenter: Yusuf Surucu
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: J. Peter Rubin, MD, MBA
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Introduction:
Peripheral nerve repair (PNR) is often prone to recurrence and suboptimal results. Human amniotic membrane (HAM) has regenerative properties. In this literature review, we assessed the use of HAM-derived commercial products in PNR.
Methods:
A systematic literature search was conducted utilizing PubMed and search engines, using relevant keywords to establish the body of knowledge. Significant details on products were noted. Clinical and in vivo studies are included for efficacy investigation.
Results:
30 commercially available products from 16companies were found. Thickness, form, and preservation methods varied between products. Only 4products were reported for clinical or animal use in peripheral nerve surgeries(3human,1rat). AlloWrap(Stryker) was used as a wrap in a single patient thoracic outlet syndrome case report and showed efficacy in preventing neural adhesions. Cygnus(Vivex) was wrapped around a 1 cm rat sciatic nerve bridging allograft and compared to collagen or no wrap cohorts. Amnion-wrapped group achieved better nerve regeneration and minimal fibrosis. Amniofix(Mimedx) was used in 58 patients during nerve-sparing radical prostatectomy. In a score-matched analysis, HAM cohort showed superior mean time to continence and potency. A case series on 8 patients with recurrent cubital tunnel syndrome used XWrap(AppliedBiologics) to wrap the scarred ulnar nerve after decompression. Treatment significantly improved pain levels, disability scores, pinch strength, and elbow motion. No study reported side effects.
Conclusions:
There is limited information on the use of HAM products for peripheral nerve repair. However, reported success indicates that the exploration of HAM-based products in PNR is promising for the enhancement of patient outcomes.
