Autograft repairs remain inferior to primary neurorrhaphy, largely due to axonal regeneration across two coaptation sites. PEG–mediated neurorrhaphy has been shown to enhance recovery following peripheral nerve injury by mitigating Wallerian degeneration. Whether PEG can overcome these limitations in human autografts remains unclear. We therefore compared sensory recovery following PEG-mediated primary versus PEG-mediated autograft neurorrhaphy. In this study, prospectively collected clinical data were analyzed for patients undergoing PEG-mediated nerve repair with follow-up to 100 days. Sensory recovery was assessed using two MRCC grading groups: < 3 (no recovery) and ≥ 3 (recovery). Differences across postoperative timepoints between the two groups were analyzed using the Kruskal–Wallis test with Dunn’s post hoc testing and Bonferroni correction. A total of 48 PEG-mediated nerve repairs (42 primary, 6 autograft) were analyzed. The two groups were similar except for shorter operative time in the primary repairs (172.6 ± 124.4 vs. 262.0 ± 80.8 min, p = 0.047). The primary repairs showed significantly lower numbers of MRCC sensory grade ≥ 3 across the follow-ups (Z = − 2.18, p = 0.029). Overall, PEG-mediated autograft repairs may enhance outcomes following peripheral nerve autografting. This study represents the first human comparison of PEG-mediated neurorrhaphy techniques and warrant validation in larger studies.
Gutama et al. (Wed,) studied this question.