Remplir Nerve Wrap Info
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
What is it
A Remplir nerve wrap is a protective sleeve made from natural pig tissue. It is used during nerve surgery to help repair damaged nerves. This device addresses the problem of scar tissue forming at the repair site. Scar tissue can block nerve signals and slow down healing.
The wrap acts as a biological barrier around the sutured nerve. It reduces the amount of collagen that builds up inside the repair site. This helps keep the area clear for nerve recovery. We use this wrap to support your nerve during the healing process. It provides a stable environment for your nerve to regenerate without excessive scarring.
What it's made of
The wrap is made from biological material processed from animal tissue. It is designed to sit around the nerve to help guide healing. Your surgeon places it during the procedure to support the repair site.
This material is not permanent. It breaks down and dissolves in your body over time as the nerve heals. The process removes cells to ensure safety, leaving behind a supportive structure that encourages natural tissue remodeling.
How your surgeon uses it
Your surgeon may use a porcine extracellular matrix nerve wrap during primary epineurial repair. This is a direct repair of the outer layer of a nerve. The wrap is placed around the coaptation site, which is where the nerve ends are joined. It helps reduce collagen deposition in this area. However, it does not improve axonal regeneration, neuromuscular junction reinnervation, or functional recovery compared to primary epineurial repair alone.
We also use this wrap during secondary decompression for recurrent cubital tunnel syndrome. This is a safe and effective treatment when symptoms return. In some cases, your surgeon may use purified type 1 bovine collagen conduits to repair median nerves in the distal forearm. These conduits act as tubes to bridge gaps in digital sensory nerves up to 3 cm long. They help restore sensation and avoid the need for nerve autografts, which take tissue from another part of your body. Processed nerve allografts are another option for gaps under 3 cm, showing earlier improved outcomes at 6 months compared to nerve conduits.
What to expect
Your surgeon uses a wrap made from natural tissue to cover the repaired nerve. This material helps reduce scar tissue buildup at the repair site. It does not speed up nerve regrowth or improve muscle function compared to standard repair alone. Your recovery follows the same path as the main operation. Please refer to that procedure’s page for specific timelines and rehab steps.
The wrap is designed to dissolve into your body over time. You do not need to worry about it showing up on future X-rays or MRIs. It is not visible on standard imaging scans. If you have questions about scar tissue or nerve sensation, we can discuss these during your follow-up visits. Our team will guide you through the standard recovery process for your specific surgery.
What the evidence says
Studies show that using a porcine extracellular matrix nerve wrap during primary nerve repair does not improve axonal regeneration, neuromuscular junction reinnervation, or functional recovery compared to repair alone. It does, however, reduce collagen deposition within the repair site. This material is also an effective and safe option when combined with secondary decompression for recurrent cubital tunnel syndrome.
For digital nerve gaps of 3 cm or less, collagen nerve tubes offer a clinically effective way to restore sensation. They avoid the donor site issues associated with nerve autografts. At 12 months of follow-up, nerve conduits and processed nerve allografts provide equally effective reconstruction of sensation for these gaps. However, processed nerve allografts show earlier improved outcomes at 6 months compared to nerve conduits.
Nerve autografts remain the benchmark for larger, longer, mixed, or motor nerve defects. In animal models, autografts provided superior motor nerve recovery over collagen nerve conduits for a 10-mm nerve gap. Biodegradable nerve conduits also offer a protective effect against peripheral nerve adhesion after neurolysis. The evidence is still building for some applications, and longer-term studies are needed to fully understand all outcomes.
