Degenerated nerve grafts provide similar quality and outcome in reconstructing critical nerve defects as compared to fresh nerve grafts.

Introduction: Brachial plexus injuries are commonly caused by stretch-traction injuries. The clinical standard is timely anatomic reconstruction with autologous nerve grafts and/or intra- or extraplexal nerve transfers. Commonly used nerve grafts are the sural nerves and/or grafts taken from the affected side. If the lower trunk has been affected, the latter nerves, however, are predegenerated. In this animal experiment we investigated, whether a degenerated nerve graft avails the same quality of regeneration as compared to a non-degenerated graft. Methods and materials: In this animal study, a 2 cm lesion of the right common peroneal nerve was created, and the ipsilateral sural nerve was cut or left intact to later serve as a graft. Nerve reconstruction was carried out 3 weeks later using the fresh or degenerated graft. After 6 weeks, either a retrograde labeling of the common peroneal nerve or muscle force testing was performed. Results: A total of 34 male SD rats, Group A ( Conclusion: The use of predegenerated nerve grafts for critical nerve reconstruction showed no statistical inferiority as compared to the fresh grafts in any of the evaluated outcome. Overall, these results are promising, particularly in the context of critical nerve defects involving multiple nerves, where the use of a degenerated grafts often remains the only additional source of graft material.