Repairing a 35-mm-long median nerve defect with a chitosan/PGA artificial nerve graft in the human: a case study.

We have developed a chitosan/polyglycolic acid (PGA) artificial nerve graft which was previously used for bridge implantation of dog sciatic nerves across 30-mm long defects. Here we describe a clinical trial of this graft for repairing a 35-mm-long median nerve defect at elbow of a human patient. During the 3-year follow-up period, functional recovery of the injured median nerve was assessed by pinch gauge test, hydraulic hand dynamometry, static two-point discrimination and touch test with monofilaments, in couple with electrophysiological examinations. The motor and sensory function of the median nerve demonstrated an ongoing recovery postimplantation, reaching M4 and S3+ levels during the follow-up period. The results indicate that the chitosan/PGA artificial nerve graft could be used for surgical repair of larger defects in major peripheral nerves at a higher level in the human. (c) 2008 Wiley-Liss, Inc. Microsurgery, 2008