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

Microsurgery ◽  
2020 ◽  
Vol 40 (6) ◽  
pp. 710-716 ◽  
Author(s):  
Ivica Ducic ◽  
Joshua Yoon ◽  
Gregory Buncke
2020 ◽  
Vol 45 (1) ◽  
pp. 132-140
Author(s):  
Vera S. Schellerer ◽  
Lenka Bartholomé ◽  
Melanie C. Langheinrich ◽  
Robert Grützmann ◽  
Raymund E. Horch ◽  
...  

Abstract Background Management of donor site closure after harvesting a vertical rectus abdominis myocutaneous (VRAM) flap is discussed heterogeneously in the literature. We aim to analyze the postoperative complications of the donor site depending on the closure technique. Methods During a 12-year period (2003–2015), 192 patients in our department received transpelvic VRAM flap reconstruction. Prospectively collected data were analyzed retrospectively. Results 182 patients received a VRAM flap reconstruction for malignant, 10 patients for benign disease. The median age of patients was 62 years. 117 patients (61%) received a reconstruction of donor site by Vypro® mesh, 46 patients (24%) by Vicryl® mesh, 23 patients (12%) by direct closure and 6 patients (3%) by combination of different meshes. 32 patients (17%) developed in total 34 postoperative complications at the donor site. 22 complications (11%) were treated conservatively, 12 (6%) surgically. 17 patients (9%) developed incisional hernia during follow-up, with highest incidence in the Vicryl® group (n = 8; 17%) and lowest in the Vypro® group (n = 7; 6%). Postoperative parastomal hernias were found in 30 patients (16%) including three patients with simultaneous hernia around an urostomy and a colostomy. The highest incidence of parastomal hernia was found in patients receiving primary closure of the donor site (n = 6; 26%), the lowest incidence in the Vypro® group (n = 16; 14%). Conclusion The use of Vypro® mesh for donor site closure appears to be associated with a low postoperative incidence of complications and can therefore be recommended as a preferred technique.


BMC Surgery ◽  
2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Alexander Hallgren ◽  
Anders Björkman ◽  
Anette Chemnitz ◽  
Lars B Dahlin

2006 ◽  
Vol 57 (4) ◽  
pp. 391-395 ◽  
Author(s):  
Frank F. A. IJpma ◽  
Jean-Phillipe A. Nicolai ◽  
Marcel F. Meek

Author(s):  
Tonya J. Whitehead ◽  
Harini G. Sundararaghavan

Peripheral nerve injury can cause lifelong pain, loss of function, and decreased quality of life. The gold standard of repair is a nerve autograft; however this requires additional surgeries and can cause donor site morbidity. As an alternative, nerve growth conduits are being developed to guide he existing nerves to cross these injured gaps. Electrospinning has emerged as a popular method to produce fibrous scaffolds for use in tissue engineering applications. However, limited work has been done electrospinning Hyaluronic Acid (HA) a major component of the extra cellular matrix. Cells respond to several factors in their environment including chemical, mechanical, topographical and adhesion cues.1 Using electrospinning along with microspheres allows us to control mechanical, topographical, and chemical signals within our scaffold. Axons are known to respond to topographical cues, prefer ‘soft’ substrates and grow faster in the presence of Nerve Growth Factor (NGF). We can precisely control the mechanics of our scaffold by conjugating methacrylates to the HA backbone and crosslinking under UV light. We also use the rotation speed of the collection mandrel to create fibers that are aligned along one axis. Adhesivity is achieved by coating the finished scaffold with fibronectin. Microspheres are included to release protein and create a chemical signal. These characteristics combined mimic the natural environment of nervous tissue.


2020 ◽  
Vol 2 (2) ◽  
pp. 74-76 ◽  
Author(s):  
Kaoru Tada ◽  
Mika Nakada ◽  
Masashi Matsuta ◽  
Daisuke Yamauchi ◽  
Kazuo Ikeda ◽  
...  

2020 ◽  
Author(s):  
Quanzhe Liu ◽  
Wenlai Guo ◽  
Wenrui Qu ◽  
Xiaolan Ou ◽  
Rui Li ◽  
...  

Abstract Background: The treatment of defects on the volar surface of the finger has been scarcely reported, and its utility for digital resurfacing remains unclear. This study compared the outcomes of free medial plantar artery flap (MPAF) and dorsal digital–metacarpal flap (DDMF) in finger reconstruction.Methods: This retrospective cohort study included 24 patients with soft-tissue defects on the volar surface of the finger from March 2014 to March 2017. The patients were divided into two groups: the MPAF group and the DDMF group. The operation time, complications, such as flap necrosis, graft loss, infection, paresthesia, and donor-site morbidity, as well as two-point discrimination (2-PD) were carefully recorded. The Michigan Hand Outcomes Questionnaire was used for conduct follow-up assessment.Results: After more than 12 months of follow-up, the MPAF group had a longer operative time compared with DDMF group, but there was no significant difference in postoperative complications and the results (2-PD and Modified VSS score) were significant. In terms of overall function, MPAF was superior to DDMF (p < 0.005).Conclusion: MPAF and DDMF are reliable for reconstruction of the volar surface of the finger; however, MPAF offers better functional outcomes and is associated with a lower incidence of postoperative complications.


2002 ◽  
Vol 48 (4) ◽  
pp. 449-450 ◽  
Author(s):  
Reha Yavuzer ◽  
G??ne?? Yavuzer ◽  
S??reyya Ergin ◽  
Osman Latifo??lu

Hand ◽  
2017 ◽  
Vol 13 (6) ◽  
pp. 621-626 ◽  
Author(s):  
Hyuma A. Leland ◽  
Beina Azadgoli ◽  
Daniel J. Gould ◽  
Mitchel Seruya

Background: The purpose of this study was to systematically review outcomes following intercostal nerve (ICN) transfer for restoration of elbow flexion, with a focus on identifying the optimal number of nerve transfers. Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify studies describing ICN transfers to the musculocutaneous nerve (MCN) for traumatic brachial plexus injuries in patients 16 years or older. Demographics were recorded, including age, time to operation, and level of brachial plexus injury. Muscle strength was scored based upon the British Medical Research Council scale. Results: Twelve studies met inclusion criteria for a total of 196 patients. Either 2 (n = 113), 3 (n = 69), or 4 (n = 11) ICNs were transferred to the MCN in each patient. The groups were similar with regard to patient demographics. Elbow flexion ≥M3 was achieved in 71.3% (95% confidence interval [CI], 61.1%-79.7%) of patients with 2 ICNs, 67.7% (95% CI, 55.3%-78.0%) of patients with 3 ICNs, and 77.0% (95% CI, 44.9%-93.2%) of patients with 4 ICNs ( P = .79). Elbow flexion ≥M4 was achieved in 51.1% (95% CI, 37.4%-64.6%) of patients with 2 ICNs, 42.1% (95% CI, 29.5%-55.9%) of patients with 3 ICNs, and 48.4% (95% CI, 19.2%-78.8%) of patients with 4 ICNs ( P = .66). Conclusions: Previous reports have described 2.5 times increased morbidity with each additional ICN harvest. Based on the equivalent strength of elbow flexion irrespective of the number of nerves transferred, 2 ICNs are recommended to the MCN to avoid further donor-site morbidity.


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