It is about 25 years that tubular nerve guides have been introduced into clinical practice as an alternative to autograft in nerve-injuries, bringing the advantage of avoiding donor site sacrifice and morbidity. However the human nerve regeneration in the guides has never been extensively verified. We implanted nerve-guides in patients with gap-injuries up to 30 millimetres, from elbow to fingers. Most of patients were treated in emergency and presented associated lesions. We proposed a collagen implant (NeuroMatrix, Stryker+ or, Neuragen, Integra) and more recently a chitosan implant (Reaxon) as an option to autologous grafting or neurectomy, informing the patients that a second operation could be enterprised like, for example, a tenolysis in multiple tendon lesions. During these successive surgery we had a second-look at nerve-guides and assessed macroscopically what was inside. In the last nine years we used 88 implants on wrist and hand. 32 digital+ 16 metacarpal+ 19 median nerve+ 14 ulnar nerve+ 7 superficial radial nerves. Protective sensory recovery and motor function was assessed by clinical examination. We performed 26 second-look− 7 in digital+ 2 in metacarpal+ 8 in median+ 5 in ulnar+ 4 in superficial radial implants. Digital implants showed a good sensory recovery and absence of painful neuroma. Second look showed a nerve-regenerate inside all guides. In metacarpal implants there was absence of painful neuroma, however the sensory recovery was obtained only in 8 patients. In median implants there was absence of painful neuroma and sensory recovery in 14 cases, however motor recovery was not obtained in 6 cases. Second-look showed a regenerate of variable entity. In ulnar implants there was absence of painful neuroma but sensory recovery was present in only 5 short-gap lesions and motor recovery in only 2+ second-look showed a regenerate only in the guides with recovery. In all superficial radial implants there was, notably, absence of painful neuroma+ sensory recovery was present in 5 cases. Second-look showed a regenerate in highly degraded guides. Pain was never recorded in this series. An adequate sensory recovery occurred in all patients where a nerve-regenerate was found inside the guide. Motor recovery seemed to be confined only in gap-lesion shorter than 10 millimetres. All patients who received the second-look operation were satisfied of further improvement in their condition.