Morbidity following sural nerve harvesting: A prospective study

Martins, Roberto S.; Barbosa, Rafael A.; Siqueira, Mário G.; Soares, Matheus Schmidt; Heise, Carlos Otto; Foroni, Luciano; Teixeira, Manoel J.

doi:10.1016/j.clineuro.2012.02.045

Cited by 32 publications

(20 citation statements)

References 19 publications

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“…With this in mind, the nerve harvest procedure can be considered a safe procedure in healthy individuals. The results correlate well with previously published studies [5-9,11], where it was concluded that the majority of patients tolerate harvest of a sural nerve well and that there are only minor persisting symptoms from the donor site, which was irrespective of the length of follow up. Such statement has also been emphasized in paediatric patients [7].…”

Section: Discussionsupporting

confidence: 91%

“…Interestingly, the patients experienced that the area of sensory loss in the skin decreased over time. In accordance, healthy subjects also notice a similar phenomenon after a sural nerve biopsy [4,9,10,12]. Previous studies, based on telephone interviews, did not focus on reduction of the sensory loss [6,11].…”

Section: Discussionmentioning

confidence: 64%

“…Previous studies, based on telephone interviews, did not focus on reduction of the sensory loss [6,11]. The gradual decrease of the area of sensory loss may depend on a combination of collateral sprouting from sensory nerves adjacent to the cutaneous area formerly innervated by the sural nerve [9,12] and brain plasticity [6,9,13]. Information, regarding the possibility for sensory loss around the heel and lateral foot and that this area may decrease over time as well as information about mild or intermittent allodynia seen in 50% of the patients, should be provided to the patients before harvesting the sural nerve.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the sural nerve is the most common autologous donor nerve, in nerve grafting, to reconstruct severe nerve defects in both adults and children. Although the sural nerve is extensively used as a donor nerve, a limited number of studies have investigated the sequelae following harvesting of the sural nerve [5-9], particularly as related to the symptoms seen in subjects and patients that have undergone a sural nerve biopsy.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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BackgroundThe 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.MethodsForty-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.ResultsForty-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.ConclusionsHarvesting 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.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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“…Commonly the sensory sural nerve, which innervates the foot, is used. However, studies have shown a loss in sensitivity and pain can be caused by the removal of the sural nerve [3,9,10]. The requirement of multiple surgeries is not unusual and there are a limited number of autologous donor nerves available.…”

Section: Introductionmentioning

confidence: 99%

Additive manufactured biodegradable poly(glycerol sebacate methacrylate) nerve guidance conduits

et al. 2018

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Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy

Dučić

Yoon

Buncke³

2020

Microsurgery

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Background The sural nerve is the most frequently harvested nerve autograft and is most often biopsied in the workup of peripheral neuropathy. While the complication types associated with these two procedures are well known, their clinical significance is poorly understood and there is a paucity of data regarding the complication rates. Methods Pubmed search identified studies regarding complications after sural nerve harvest and biopsy. The data was grouped into sensory deficits, chronic pain, sensory symptoms, wound infections, wound complications, other postoperative complications, and complications impacting daily life. The incidence of each complication was calculated, and a chi‐square analysis was performed to determine if there were any differences between nerve biopsies and graft harvest with respect to each complication. Results Twelve studies yielded 478 sural nerve procedures. Sensory deficits occurred at a rate of 92.9%, chronic pain at 19.7%, sensory symptoms at 41.1%, wound infections at 5.7%, noninfectious wound complications at 7.8%, and impact on daily life at 5.0%. The differences in wound infections, sensory symptoms, and impact on daily life between biopsies versus graft excisions were found to reach statistical significance (p < .05). Conclusions Sural nerve excisions can cause chronic postoperative donor‐site complications. Given these complications, alternative available mediums for nerve reconstruction should be explored and utilized wherever appropriate. If an alternative medium is unavailable and nerve autograft must be harvested for nerve reconstruction, then patients should be counseled about risks for developing donor site complications that may negatively affect quality of life.

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Morbidity following sural nerve harvesting: A prospective study

Cited by 32 publications

References 19 publications

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

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

Additive manufactured biodegradable poly(glycerol sebacate methacrylate) nerve guidance conduits

Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy

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