Hyperbaric oxygenation in peripheral nerve repair and regeneration

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Neurol Res. 2007 Mar;29(2):184-98.

Hyperbaric oxygenation in peripheral nerve repair and regeneration.

EC.

Hyperbaric Medicine Department, Hospital Angeles del Pedregal,

Mexico, DF, Mexico.

Peripheral nerves are essential connections between the central

nervous system and muscles, autonomic structures and sensory organs.

Their injury is one of the major causes for severe and longstanding

impairment in limb function. Acute peripheral nerve lesion has an

important inflammatory component and is considered as ischemia-

reperfusion (IR) injury. Surgical repair has been the standard of

care in peripheral nerve lesion. It has reached optimal technical

development but the end results still remain unpredictable and

complete functional recovery is rare.

Nevertheless, nerve repair is not primarily a mechanical problem and

microsurgery is not the only key to success. Lately, there have been

efforts to develop alternatives to nerve graft.

Work has been carried out in basal lamina scaffolds, biologic and

non-biologic structures in combination with neurotrophic factors

and/or Schwann cells, tissues, immunosuppressive agents, growth

factors, cell transplantation, principles of artificial sensory

function, gene technology, gangliosides, implantation of microchips,

hormones, electromagnetic fields and hyperbaric oxygenation (HBO).

HBO appears to be a beneficial adjunctive treatment for surgical

repair in the acute peripheral nerve lesion, when used at lower

pressures and in a timely fashion (<6 hours).