Tiam Mana Saffari

258 CHAPTER 12 broad spectrum of paracrine actions, not solely induced by the secretion of VEGF, and provides an anti-inflammatory microenvironment. This environment is suggested to enhance revascularization of the decellularized nerve allograft, diminish nerve fibrosis and subsequently improve nerve regeneration. A pedicled adipofascial flap is a durable and simple technique to provide vascularization to the nerve wound bed and create such an microenvironment. Both the provision of undifferentiated and differentiated MSCs improved functional outcomes of decellularized nerve allografts. The delivery of undifferentiated MSCs is favored considering the shorter culture time and the greater functional recovery that was achieved. The combination of undifferentiated MSCs and angiogenesis specifically, leads to the increase of quality (i.e. size and distribution) of vessels and is postulated to regulate directionality of vessels. The distribution and direction of newly formed vessels are believed to be equally important to facilitate axonal outgrowth.