Vascularized nerve grafts. A practical approach

VNGs theoretically have several advantages over CNGs and therefore may produce better functional results. Use of VNGs is indicated in severely scarred recipient beds, but in beds that are less compromised, VNGs may not perform better than CNGs. The anatomy of the nerve's blood supply, methods of vascularizing a nerve graft, methods of forming cable grafts and maintaining vascular supply, and techniques for monitoring the VNG must all be understood before the surgeon can successfully transfer one of the six potential VNGs. Some clinical evidence indicates that VNGs may be superior to CNGs in moderately scarred recipient beds and, with more certainty, in digital nerve reconstruction.