Emerging technologies in peripheral nerve repair: Improving regenerative outcomes and reducing morbidity

Having affected 1 million people per year, PNIs cause serious sensory, motor, and autonomic impairment, involving devastating clinical complications. Existing interventions such as autografts and allografts present many unsatisfactory outcomes as the axonal regeneration remains slow, neuroma develops, and the donor site presents itself with morbidity. A literature review examines the innovative technologies revolutionizing the repair of peripheral nerves, with a focus on maximizing regeneration and minimizing complications. Enhanced guidance of axons is achieved with advanced biomaterials, such as 3D-printed patient-specific nerve guidance conduits filled with neurotrophic factors (e.g., nerve growth factor, brain-derived neurotrophic factor). Mesenchymal and induced pluripotent stem cell-derived Schwann-like cell-based stem cell therapies promote myelination and nerve damage recovery in in vivo animals. The gene editing of CRISPR/Cas9 or the improved expression of neurotrophic factors using non-viral nanoparticle vectors can be employed to counteract inflammation. Electrical stimulation and wireless biodegradable microelectrodes all induce axonal sprouting and functional improvement. The existing gap in large nerves is addressed with bioengineered tissues having a prebuilt vascular supply, and nanotechnology-based drug delivery minimizes scarring. Most of these innovations are supported by recent clinical trials and animal studies, which will provide individualized, less-invasive solutions. This paper critically assesses their mechanisms, translational challenges, and clinical potential, demonstrating that they can transform nerve repair, improve patient outcomes, and lead to reduced morbidity in the medical world.