Processed Human Nerve GraftStandard Treatment, Autogenous Nerve Graft, Direct Suture, etc.Autogenous Nerve GraftNerve Tube ConduitAutologous Breast Reconstruction with NeurotizationAutologous Breast Reconstruction without Neurotization
Processed Human Nerve Graft: Implantation of appropriate length of processed human nerve graft at the time of surgery
Standard Treatment, Autogenous Nerve Graft, Direct Suture, etc.: Historical control from established literature
Autogenous Nerve Graft: Nerve gap reconstructions with autogenous nerve graft within the upper extremity
Nerve Tube Conduit: Nerve gap reconstructions with nerve tube conduit within the upper extremity
Study summary
This study is a registry of general use of Avance Nerve Graft and is intended to evaluate the uses, response rates, and safety of Avance Nerve Graft in the real-life clinical setting. Optional addendums 1 and 2 included in the protocol are intended to establish comparative groups and focused subgroups within the registry.
Eligibility
Sex
ALL
Min age
—
Max age
—
Healthy volunteers
No
Primary Study Criteria (RANGER Avance):
Inclusion Criteria:
* Males and Females who have undergone nerve repair using the Avance® Nerve Graft for the repair of a nerve injury
* Returned for at least one post-operative follow-up visit
Exclusion Criteria:
• Subject who in the opinion of the investigator, have not or likely will not complete at least some portion of the investigator's recommended follow-up.
Addendum 1 (MATCH) Criteria:
Inclusion Criteria:
* Have nerve transection injuries to the upper extremity;
* Have undergone tension free end to end nerve coaptation on both the proximal and distal portion of the nerve gap with nerve autograft or nerve entubulation with nerve tube conduit at a participating ANG-CP-005 registry site after 2004 and;
* Have completed sufficient follow-up assessments at a regeneration rate of 2mm/day to determine the outcomes of the repair or is willing to comply with site specific post-operative care procedures and assessments to determine the outcome of the repair.
Exclusion Criteria:
* Direct nerve repairs;
* Nerve gaps greater than 70mm;
* Subjects who, in the opinion of the investigator, were non-compliant to the investigator's post-operative treatment or rehabilitation instructions;
* Any subject who at the discretion of the Investigator is not suitable for inclusion in the study.
Addendum 2 (Sensation-NOW) Criteria:
Inclusion Criteria:
* Female ≥ 18 years old
* Undergo post mastectomy autologous breast reconstruction with one type of autologous flap (no stacked reconstructions or use of implant with autologous flap)
* Neurotization must be completed using a donor nerve from the flap and a recipient nerve from the chest
* Complete Sensory Assessment Testing with Semmes Weinstein Monofilaments (SWMF) and the following Breast-Q Questionnaires 60 - 120 days post-reconstruction:
* Breast-Q Physical Well Being of the Chest
* Breast-Q Satisfaction with Breast
* Breast-Q Physical Well Being of the Abdomen
* Breast-Q Abnormal Breast Sensations
* Breast-Q Impact of Breast Sensation on Quality of Life
* Breast-Q Return of Breast Sensation
* Able to provide informed consent and are willing to comply with post-operative care procedures and assessments
Exclusion Criteria:
* Surgical history of secondary revision surgery for partial or total flap loss
* Bilateral reconstruction with non-uniform treatment (i.e. 1 reconstructed breast is non-neurotized, 1 reconstructed breast is neurotized)
* Currently prescribed medication known to impact nerve regeneration or to cause peripheral neuropathy
* Currently undergoing IV chemotherapy or radiation
* Any subject who at the discretion of the Investigator is not suitable for inclusion in the study or is unlikely to comply with follow-up schedule
Additional Eligibility criteria to Modules
Module 1: Native Skin Reconstructions with and without neurotization.
* Buried flap reconstructions from nipple sparing mastectomy or skin sparing mastectomy OR a breast reconstruction from a skin sparing mastectomy with exposed flap skin in the peri-areolar region.
* Sensory assessments must be completed on ≥ 8 Zones of Native Skin.
* Center zone measurement may be on either Native Skin or Flap Skin.
* All Inner and Outer zone measurements must be on Native Skin.
* De-identified photo of the breast reconstruction with 9 zones identified.
Primary outcome measure(s)
Avance Nerve Graft: Incidence of Avance Nerve Graft Related Adverse Events — Through study completion or until lost to follow-up, approximately 3 years Participants will be followed through the course of their recovery based on Physician's standard of care practice or until lost to follow-up.
RANGER and MATCH: Sensory Function as measured by Medical Research Council Classification (MRCC) for sensory recovery — Through study completion or until lost to follow-up, approximately 3 years Participants will be followed for a change in sensory function, if applicable, of the reconstructed peripheral nerve through the course of their follow-up using Physician's standard of care sensory assessments or until lost to follow-up.
RANGER and MATCH: Motor Function as measured by Medical Research Council Classification (MRCC) for motor recovery — Through study completion or until lost to follow-up, approximately 3 years Participants will be followed for a change in motor function, if applicable, to the reconstructed peripheral nerve through the course of their follow-up using Physician's standard of care motor assessments or until lost to follow-up.
Sensation-NOW- Breast Neurotization: Sensory Function Post Autologous Breast Reconstruction — Through study completion or until lost to follow-up, approximately 3 years Participants will be followed for change in sensation through the course of their recovery using Physician's standard of care assessments or until lost to follow-up. Standard of care sensory assessment includes evaluation using Semmes Weinstein Monofilament kit measured in g/mm2.
Sensation-NOW- Breast Neurotization: Quality of Life Measurement Post Autologous Breast Reconstruction — Through study completion or until lost to follow-up, approximately 3 years Participants will be followed for change in quality of life as measured by Breast Q through the course of their recovery or until lost to follow-up using Physician's standard of care assessments. Standard of care assessments may include evaluation of quality of life via other scales or may be qualitatively documented.
Incidence of conduit, autograft, or procedure related adverse events — Through study completion or until lost to follow-up, approximately 3 years Participants will be followed through the course of their recovery based on Physician's standard of care practice or until lost to follow-up.
Trial sites (49)
Facility
City
Region
Status
RANGER & MATCH: Arizona Center for Hand Surgery
Phoenix
Arizona
RANGER: Phoenix Children's Hospital
Phoenix
Arizona
RANGER & MATCH: University of California - Irvine
Orange
California
RANGER & MATCH: The Buncke Clinic
San Francisco
California
Sensation-NOW: Stanford University
Stanford
California
Sensation-NOW: University of Colorado School of Medicine
Aurora
Colorado
Sensation-NOW: George Washington University
Washington D.C.
District of Columbia
RANGER: University of Miami
Miami
Florida
RANGER & MATCH: Florida Orthopaedic Institute
Tampa
Florida
RANGER: Hand & Upper Extremity Center of Georgia/Children's Hospital of Atlanta
Atlanta
Georgia
RANGER & MATCH: University of Kansas Medical Center
Kansas City
Kansas
Sensation-NOW: University of Kansas Medical Center
Kansas City
Kansas
RANGER: University of Kentucky
Lexington
Kentucky
Sensation-NOW: Advanced Reconstructive Care, LLC
Metairie
Louisiana
RANGER: Johns Hopkins University
Baltimore
Maryland
Sensation-NOW: Johns Hopkins University
Baltimore
Maryland
RANGER: Walter Reed National Military Medical Center
Bethesda
Maryland
MATCH: Hennepin County Medical Center
Minneapolis
Minnesota
RANGER & MATCH: University of Missouri - Columbia
Columbia
Missouri
Sensation-NOW: University of Nebraska Medical Center
Omaha
Nebraska
Sensation-NOW: University of Nevada, Las Vegas
Las Vegas
Nevada
RANGER: Multi-Disciplinary Specialists
Rutherford
New Jersey
RANGER & MATCH: OrthoCarolina Research Institute, Inc.
Charlotte
North Carolina
RANGER: Duke University
Durham
North Carolina
RANGER: University of Cincinnati
Cincinnati
Ohio
Sensation-NOW: University of Cincinnati
Cincinnati
Ohio
RANGER: Cleveland Clinic
Cleveland
Ohio
RANGER: Ohio State University Medical Center
Columbus
Ohio
Sensation-NOW: Ohio State University Medical Center
Columbus
Ohio
Sensation-NOW: University of Pennsylvania
Philadelphia
Pennsylvania
Sensation-NOW: East Cooper Plastic Surgery
Mt. Pleasant
South Carolina
RANGER & MATCH: Campbell Clinic
Germantown
Tennessee
RANGER & MATCH: Vanderbilt University
Nashville
Tennessee
Sensation-NOW: Vanderbilt University
Nashville
Tennessee
Sensation-NOW: University of Texas Southwestern Medical Center
Dallas
Texas
RANGER: University of North Texas/John Peter Smith Hospital
Fort Worth
Texas
Sensation-NOW: University of North Texas/John Peter Smith Hospital
Fort Worth
Texas
Sensation-NOW: Baylor College of Medicine
Houston
Texas
Sensation-NOW: Houston-Methodist Central
Houston
Texas
Sensation-NOW: Houston-Methodist West/North
Houston
Texas
+ 9 more sites — see the full list on the official registry below.
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
We use cookies to analyse site traffic and improve your experience. With your consent, we may also use cookies for advertising. You can change your choice at any time.