Methods: The composite transplant is composed of the following elements: 1. A tissue engineered tubular guiding neurotube, made of a biodegradable co-polymer, which provides guidance for the regenerating axons. 2. A viscous gel, containing growth factors, neurotrophic and neuroprotective agents (which are all slowly releasing), providing an excellent milieu inside the neurotube for growth of axons. 3. Cultured rat schwann cells Surgery was performed on 20 three-month-old Wister rats. The sciatic nerve of the rats was completely transected and peripheral nerve segment was removed. The rats were divided into two groups: I- composite transplant with schwann cells (5rats) or without (5 rats), was placed between the proximal and the distal parts of the transected nerve for reconnection of 2cm long distance. II- polyglycolic neurotube containing gel with growth factors, neurotrophic and neuroprotective agents (5 rats) or without gel, factors and agents (5rats) was used for reconnection of 1cm long distance. The proximal and distal parts of the nerve were fixed into the neurotube using 10-0 sutures.

Results: The post-operative follow-up (up to 3 months) on the operated rats which underwent peripheral nerve reconstruction showed re-establishment of active foot movements in both groups: in the first group where composite transplant containing schwann cells and in second group where gel containing growth factors, neurotrophic and neuroprotective agents were used. The tube was dissolved and nerve showed complete reconnection. Histological observation of the nerve showed growth of myelinated axons in the place where nerve defect was replaced by composite nerve transplant with schwann cells or polyglycolic acid tube containing gel with growth factors and neurotrophic agents and continuation of axonal sprouting through the place of the tube to the distal part of the nerve.

Conclusion: 1.An innovative composite implant for reconstruction of significant peripheral nerve defect is described. 2. A viscous gel, containing growth factors and neuroprotective agents with or without schwann cells served as regenerative and repair source.