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Subjective outcome related to donor site morbidity after sural nerve graft harvesting: a survey in 41 patients

Hallgren, Alexander; Björkman, Anders LU ; Chemnitz, Anette LU and Dahlin, Lars LU (2013) In BMC Surgery 13.
Abstract
Background: The sural nerve is the most commonly used nerve for grafting severe nerve defects. Our aim was to evaluate subjective outcome in the lower leg after harvesting the sural nerve for grafting nerve defects. Methods: Forty-six patients were asked to fill in a questionnaire to describe symptoms from leg or foot, where the sural nerve has been harvested to reconstruct an injured major nerve trunk. The questionnaire, previously used in patients going through a nerve biopsy, consists of questions about loss of sensation, pain, cold intolerance, allodynia and present problems from the foot. The survey also contained questions (visual analogue scales; VAS) about disability from the reconstructed nerve trunk. Results: Forty-one out of 46... (More)
Background: The sural nerve is the most commonly used nerve for grafting severe nerve defects. Our aim was to evaluate subjective outcome in the lower leg after harvesting the sural nerve for grafting nerve defects. Methods: Forty-six patients were asked to fill in a questionnaire to describe symptoms from leg or foot, where the sural nerve has been harvested to reconstruct an injured major nerve trunk. The questionnaire, previously used in patients going through a nerve biopsy, consists of questions about loss of sensation, pain, cold intolerance, allodynia and present problems from the foot. The survey also contained questions (visual analogue scales; VAS) about disability from the reconstructed nerve trunk. Results: Forty-one out of 46 patients replied [35 males/6 females; age at reconstruction 23.0 years (10-72); median (min-max), reconstruction done 12 (1.2-39) years ago]. In most patients [37/41 cases (90%)], the sural nerve graft was used to reconstruct an injured nerve trunk in the upper extremity, mainly the median nerve [19/41 (46%)]. In 38/41 patients, loss of sensation, to a variable extent, in the skin area innervated by the sural nerve was noted. These problems persisted at follow up, but 19/41 noted that this area of sensory deficit had decreased over time. Few patients had pain and less than 1/3 had cold intolerance. Allodynia was present in half of the patients, but the majority of them considered that they had no or only slight problems from their foot. None of the patients in the study required painkillers. Eighty eight per cent would accept an additional sural nerve graft procedure if another nerve reconstruction procedure is necessary in the future. Conclusions: Harvesting of the sural nerve for reconstruction nerve injuries results in mild residual symptoms similar to those seen after a nerve biopsy; although nerve biopsy patients are less prone to undergo an additional biopsy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Sural nerve, Nerve reconstruction, Nerve injury, Cold intolerance, Allodynia, Pain
in
BMC Surgery
volume
13
publisher
BioMed Central
external identifiers
  • wos:000325154000001
  • scopus:84884476859
ISSN
1471-2482
DOI
10.1186/1471-2482-13-39
language
English
LU publication?
yes
id
6d864be4-9d93-40a9-b593-bdede1aa3943 (old id 4172200)
date added to LUP
2013-12-06 12:31:55
date last changed
2019-09-17 02:20:03
@article{6d864be4-9d93-40a9-b593-bdede1aa3943,
  abstract     = {Background: The sural nerve is the most commonly used nerve for grafting severe nerve defects. Our aim was to evaluate subjective outcome in the lower leg after harvesting the sural nerve for grafting nerve defects. Methods: Forty-six patients were asked to fill in a questionnaire to describe symptoms from leg or foot, where the sural nerve has been harvested to reconstruct an injured major nerve trunk. The questionnaire, previously used in patients going through a nerve biopsy, consists of questions about loss of sensation, pain, cold intolerance, allodynia and present problems from the foot. The survey also contained questions (visual analogue scales; VAS) about disability from the reconstructed nerve trunk. Results: Forty-one out of 46 patients replied [35 males/6 females; age at reconstruction 23.0 years (10-72); median (min-max), reconstruction done 12 (1.2-39) years ago]. In most patients [37/41 cases (90%)], the sural nerve graft was used to reconstruct an injured nerve trunk in the upper extremity, mainly the median nerve [19/41 (46%)]. In 38/41 patients, loss of sensation, to a variable extent, in the skin area innervated by the sural nerve was noted. These problems persisted at follow up, but 19/41 noted that this area of sensory deficit had decreased over time. Few patients had pain and less than 1/3 had cold intolerance. Allodynia was present in half of the patients, but the majority of them considered that they had no or only slight problems from their foot. None of the patients in the study required painkillers. Eighty eight per cent would accept an additional sural nerve graft procedure if another nerve reconstruction procedure is necessary in the future. Conclusions: Harvesting of the sural nerve for reconstruction nerve injuries results in mild residual symptoms similar to those seen after a nerve biopsy; although nerve biopsy patients are less prone to undergo an additional biopsy.},
  articleno    = {39},
  author       = {Hallgren, Alexander and Björkman, Anders and Chemnitz, Anette and Dahlin, Lars},
  issn         = {1471-2482},
  keyword      = {Sural nerve,Nerve reconstruction,Nerve injury,Cold intolerance,Allodynia,Pain},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Surgery},
  title        = {Subjective outcome related to donor site morbidity after sural nerve graft harvesting: a survey in 41 patients},
  url          = {http://dx.doi.org/10.1186/1471-2482-13-39},
  volume       = {13},
  year         = {2013},
}