Adapting versatile
polymers to improve
surgical outcomes
and patient recovery

NEUROCAP®

Symptomatic neuroma

Symptomatic neuroma may develop after a nerve dissection following any trauma to a peripheral nerve, whether accidental or planned (i.e. surgery). Neuroma-induced neuropathic pain and morbidity seriously affect the patient’s daily life and socioeconomic functioning. The incidence of symptomatic neuromas after peripheral nerve injury is estimated to be 3-5%, however certain surgeries (e.g. autograft procedures, amputations) may have up to a 30% incidence rate. There are several surgical procedures possible to treat symptomatic end-neuromas, but none are considered gold standard for both treatment and prevention. The most common procedure is surgical removal of the neuroma and surrounding scar tissue, and placing the proximal stump into an area subjected to minimal mechanical stimulation.

Covering the nerve stump

Covering the nerve stump with a cap of autologous material prevents both neuroma development and regeneration, but has its limitations.

  • Suitable veins need to be available and sacrificed and the stability of the treatment depends upon consistent venous integrity (i.e. no vein collapse).
  • Muscle capping is often performed as this tissue is easily available, however the recurrence of very painful sensory neuroma has been reported. Replacing the refreshed nerve end into bone is a technically demanding option. The nerve stump must be properly placed into a drilled hole, with no kinking at the hole entrance, and requires the nerve to be fixed to prevent dislocation.
  • Use of vascularized flaps is technically very demanding and only considered in specific cases Unfortunately, this way of pain treatment in amputation has an average of 2.8 re-operations and the surgeries have a failure rate of 10% or more.

Research on better fixation techniques and covering the nerve stump with synthetic material bypassing possible biocompatibility issues of animal derived materials led to the idea to develop NEUROCAP®, a nerve capping device for the treatment of neuromas. Its composition is based on the same synthetic polymers used in NEUROLAC® nerve guide for treatment of peripheral nerve lesions.

NEUROCAP®

NEUROCAP® is intended to protect a peripheral nerve end and to separate the nerve from surrounding environment to reduce the development of a symptomatic end-neuroma. NEUROCAP® is a tubular device with one open end and one closed end. Dislocation of the nerve stump is prevented by suturing the nerve end into the cap. A hole at the sealed end of the tube allows easy fixation of the nerve stump with a suture to the surrounding tissue. This allows an effective capping technique without the necessity of drilling a hole into bones, or sacrificing other tissue. For more information regarding the application and device dimensions please consult our leaflet or our instruction video.