Table 1.

Comparison of nerve barrier options based on ideal characteristics for a barrier to epineural scarring.

Ideal characteristics	Adipofascial or muscle flap	Vein wrapping	Hyaluronic acid- carboxycellulose membrane (Seprafilm)	Bovine collagen NeuraWrap; NeuraMend)	Porcine small intestine submucosa (Axoguard)
Biocompatible	Yes.	Yes	No reports of rejection.	No reports of rejection.	No reports of rejection.
	Non-absorbable	Non-absorbable	Absorbs by 7 days	Absorbs by 4–8 months	Absorbs by 3 months.
Semipermeable	Yes	Yes	Yes	Yes	Yes
Non-constricting	No reported cases of cicatrix formation after use.	No reported cases of cicatrix formation after use.	No reported cases of cicatrix formation after use.	No reported cases of cicatrix formation after use.	No reported cases of cicatrix formation after use.
Promote nerve gliding	Yes	Yes – demonstrated in animal model	Unknown	Unknown	Unknown
Minimal/no donor site morbidity	Depends on flap harvested (minimal for local fat pad flap)	Yes (typically edema)	No donor site morbidity	No donor site morbidity	No donor site morbidity
Minimal cost or supply restraints	Increased surgery time	Increased surgery time	Subject to implant cost and availability	Subject to implant cost and availability	Subject to implant cost and availability