Remplir™ is designed to meet the needs of surgeons. It is a versatile collagen nerve wrap that provides compression-free protection and an ideal microenvironment for nerve regeneration.
Orthocell has produced the ideal biomaterial to assist you to optimise your peripheral nerve repair procedures and deliver consistent and predictable patient outcomes.
The best predictor of success in peripheral nerve surgery is a tensionless, well-aligned coaptation, achieved with minimal epineurial microsutures to optimise axonal regeneration across the coaptation site.2 This can be difficult to achieve, depending on the type and location of the repair, and the predictability of outcomes following peripheral nerve repair have not substantially improved in the last several decades.3, 4
Nerve devices were introduced to improve outcomes by attempting to improve the technical quality of the coaptation, for example, requiring fewer sutures. Despite their many theoretical advantages, unfortunately, the introduction of nerve repair devices into clinical practice does not appear to have significantly improved the consistency of outcomes.5
Choice of biomaterial for nerve repair devices may have a bigger impact on nerve regeneration than was originally considered. Many of the biomaterials used to make nerve repair devices fail to fully integrate into native tissue, leaving residual material that impairs the healing process. Materials that are too rigid are challenging to deploy and make it difficult to manage size differences between nerve ends, leading to compression injuries (if too small) or neuroma formation (if too big).
By preserving the natural collagen structure, Remplir retains the inherent strength, flexibility, and biocompatibility of type I collagen.
Designed to mimic epineurium, it easily conforms to nerve tissue, accommodates size mismatches between nerve ends, and is easy to suture.
Manufactured from the highest quality porcine peritoneum and processed using the SMRT manufacturing method, the native collagen architecture is preserved without compromising strength or flexibility.
The resulting collagen structure closely resembles human collagen, making Remplir an ideal biomaterial for supporting the regeneration of healthy nerve tissue.
The SMRT manufacturing process thoroughly removes cellular impurities resulting in a pure collagen device without alpha-gal, DNA, and other non-collagenous materials that increase the risk of foreign body reaction after implantation.1
During the healing process, Remplir is completely resorbed and integrated into nerve tissue with no evidence of foreign body reaction.
The natural collagen structure of Remplir is porous, allowing nutrient flow from surrounding blood vessels.
The smooth outer surface is cell-occlusive, promoting nerve gliding through surrounding soft tissues and minimizing the risk of adhesions, while the looser arrangement of collagen fibers on the inner surface facilitates cellular attachment and proliferation.
Remplir is a highly versatile product that delivers a single solution for surgical repair of peripheral nerve injuries.
Straight out of the box - no need to soak or rinse before use
Product range covers all nerve sizes and surgical requirements
No need to accurately measure nerve diameter before selecting product
Easy to trim and shape
Remplir can be used to facilitate tensionless repair during nerve coaptation. Coaptation of nerve stumps can be achieved with one or two stay sutures, before wrapping the coaptation site with a protective layer of Remplir. If desired, Remplir can be secured to the nerve with additional microsutures, providing additional stabilisation and support for the coaptation site. Placing sutures away from the coaptation site reduces the risk of scar formation that can impede migration of regenerating axons from the proximal to distal stump.
Unlike many nerve devices, Remplir's flexibility facilitates the formation of a close seal around nerve stumps that are significantly different in size. Surgeons do not have to worry about potentially compromising clinical outcomes by selecting a product that is too small (risk of nerve compression) or too big (risk of axonal escape leading to neuroma formation).
Remplir has also been successfully used to protect coaptation sites for nerve transfer (end to end and end to side), free-functioning muscle transfer, and procedures requiring the use of nerve grafts.
Nerve wrapping with Remplir after surgical treatment for compression neuropathy can potentially improve patient outcomes. The smooth outer surface of Remplir consists of collagen bundles that are tightly packed, acting as a barrier between the epineurium and surrounding soft tissue. This feature of Remplir promotes nerve gliding and reduces the risk of adhesion formation after primary or revision surgery for compression neuropathy. As Remplir consists of collagen fibres that are similar in size and arrangement to normal human epineurium, it is an ideal scaffold for regeneration of healthy nerve tissue.
Remplir has also been successfully used as a nerve cap to prevent recurrence after surgical resection of terminal neuroma, or to prevent neuroma formation after neurectomy performed during amputation. As Remplir is a thin and flexible flat sheet, it can be easily wrapped and folded around the transected nerve end, then secured in place with sutures. There is no need to waste time in theatre measuring the diameter the nerve then selecting an appropriately sized capping device, or potentially having to compromise on treatment if the right size device isn’t in stock. The capped nerve end can then be implanted into muscle or fixed in place as desired. The close seal formed by Remplir around the nerve prevents regenerating axons from escaping, reducing the risk of neuroma formation.
Remplir is indicated for the management of peripheral nerve injuries in which there has been no substantial loss of nerve tissue.
The use of Remplir in patients with known sensitivity to porcine-derived materials or collagen is contraindicated.
OCG-152
OCG-203
OCG-304
OCG-304
*In the US this product is available for ASC's only
1. O'Beirne, A., J. Cullen, E. Landao-Bassonga, M. Zheng, C. Lee, P. Kaluskar, A. Tai and M. Zheng (2024). "Reconstruction of Upper Extremity Peripheral Nerve Injuries Using an Epineurial-Like Collagen Device—A Prospective Clinical Study." Journal of Reconstructive Microsurgery Open 09(01): e78-e88.
2. Siemionow, M. and G. Brzezicki (2009). "Chapter 8: Current techniques and concepts in peripheral nerve repair." Int Rev Neurobiol 87: 141-172.
3. Ruijs, A.C., J.B. Jaquet, S. Kalmijn, H. Giele, S.E. Hovius (2005). “Median and ulnar nerve injuries: a meta-analysis of predictors of motor and sensory recovery after modern microsurgical nerve repair.” Plast Reconstr Surg 116(2):484-94
4. Braga Silva, J., G. M. Marchese, C. G. Cauduro and M. Debiasi (2017). "Nerve conduits for treating peripheral nerve injuries: A systematic literature review." Hand Surg Rehabil 36(2): 71-85.
5. Dunlop, R. L. E., J. C. R. Wormald and A. Jain (2019). "Outcome of surgical repair of adult digital nerve injury: a systematic review." BMJ Open 9(3): e025443.