Cinal Hakan, Barin Ensar Zafer, Kara Murat, Karaduman Harun, Cengiz Ihtisam Zafer, Tan Onder, Demirci Elif
Department of Plastic Reconstructive and Aesthetic Surgery, Ataturk University School of Medicine, Erzurum, Turkey.
Department of Plastic Reconstructive and Aesthetic Surgery, Gaziosmanpasa Medical Park Hospital, İstanbul, Turkey.
Eurasian J Med. 2020 Feb;52(1):12-15. doi: 10.5152/eurasianjmed.2019.19102.
In this study, we developed a novel technique to harvest the sural nerve using the mini incisions and the carpal tunnel dilators.
The technique was applied to the 29 sides on 27 patients (24 men and 3 women). The mean age was 27.1 years (range 9-51). The diagnoses were soft tissue traumas in 23 cases, fracture in 2 cases, and previous complicated operation in 2 cases. The harmful effects of harvest procedure on the sural nerve graft were assessed double-blind histopathologically and compared with control group.
All the nerve grafts were successfully harvested with no macroscopic damage to the sural nerve graft. There was no statistically significant difference between the histopathologic scores of the distal and proximal nerve segments (p>0.05). The average follow-up time was 17 months (range 8-46). In the postoperative period, no complication such as massive bleeding/hematoma, wound infection, skin necrosis, painful neuroma formation, or prolonged calf tenderness was observed. In all cases, there were inconspicuous scars.
The method seems safe and has no damage on the nerve graft histopathologically. We believe that this technique may be used in future.
在本研究中，我们开发了一种使用小切口和腕管扩张器采集腓肠神经的新技术。
该技术应用于27例患者的29侧（24例男性，3例女性）。平均年龄为27.1岁（范围9 - 51岁）。诊断为软组织创伤23例，骨折2例，既往复杂手术2例。采用双盲组织病理学方法评估采集过程对腓肠神经移植物的有害影响，并与对照组进行比较。
所有神经移植物均成功采集，腓肠神经移植物无肉眼可见损伤。远侧和近侧神经段的组织病理学评分之间无统计学显著差异（p>0.05）。平均随访时间为17个月（范围8 - 46个月）。术后未观察到大量出血/血肿、伤口感染、皮肤坏死、疼痛性神经瘤形成或小腿长期压痛等并发症。所有病例均有不明显的瘢痕。
该方法似乎安全，且在组织病理学上对神经移植物无损伤。我们认为该技术未来可能会被应用。
