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• W4205119087 abstract "Sir: We thank Drs. Zuo and Borschel for their response to our article.1 In their letter, they highlight the limitations of our study and the requirement for well-designed animal studies to be undertaken to truly understand the strengths and limitations of acellular nerve allografts. The authors are in total agreement that animal research, particularly in the realm of peripheral nerve injury, can indeed be paradigm shifting. Animal models have existed since the early 1900s and continue to evolve, be refined, and be improved with time.2 However, no standardized model is widely used between research groups, leading to weaknesses in reproducibility and translatability of the results. In addition, over the past century, there has been a relatively slow advancement in the field of nerve regeneration despite the use of animal models, which raises significant concern, as they may not emulate the individual clinical setting of a nerve injury (e.g., vascular bed, scarring, regeneration itself). Furthermore, although chronic pain models do exist, these are also fraught with limitations.3 Other limitations of peripheral nerve research are the funding opportunities. To build a basic science peripheral nerve research program is expensive; however, the fact is that comes a very distant third behind central nervous system injury and spinal cord injury. Although there are mechanisms in place, it is perhaps wise to partner with industry and work together to produce the best alternative to autologous nerve grafts. Building these collaborations may facilitate securing the funding required to establish a multicenter, randomized, controlled trial. The intention of the article was to share our acellular nerve allograft experience and provide an overview of the outcomes that may be expected. The conclusions largely agree with both animal and clinical reports; however, the most promising outcomes demonstrated in the “chronic pain” groups are encouraging. Acellular nerve allografts avoid causing a second nerve injury at the donor site and, based on animal studies, the outcomes are superior to alternative conduit or allograft options. This is an exciting treatment modality in this patient group with the caveat being that patient selection is paramount. DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication." @default.
• W4205119087 created "2022-01-25" @default.
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• W4205119087 date "2020-11-05" @default.
• W4205119087 modified "2023-09-27" @default.
• W4205119087 title "Reply: A Retrospective Case Series Reporting the Outcomes of Avance Nerve Allografts in the Treatment of Peripheral Nerve Injuries" @default.
• W4205119087 cites W1987976939 @default.
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• W4205119087 doi "https://doi.org/10.1097/prs.0000000000007559" @default.
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