Catapano Joseph, Wong Chloe R, Sarkhosh Tara, Stefaniuk Stephanie, Dengler Jana
From the Division of Plastic and Reconstructive Surgery, St. Michael's Hospital, Toronto, Ontario, Canada.
Division of Plastic, Reconstructive and Aesthetic Surgery, University of Toronto, Toronto, Ontario, Canada.
Plast Reconstr Surg Glob Open. 2024 Sep 13;12(9):e6162. doi: 10.1097/GOX.0000000000006162. eCollection 2024 Sep.
Nerve transfer procedures are performed in patients with proximal nerve injuries to optimize their potential for functional recovery. The study aimed to determine the preferred surgical technique and tool used by peripheral nerve surgeons to transect nerves in nerve transfers.
All current members of the American Society of Peripheral Nerve were invited to complete a cross-sectional 10-question survey. Data on practice demographics, nerve-cutting instruments/techniques used, and their belief on whether this impacted patient outcomes were collected.
A total of 49 American Society of Peripheral Nerve members participated in the study, the majority of whom were over 10 years into practice (n = 30/49; 61%). The most common response was a scalpel blade (n = 26/49; 53%), with the remaining 47% using iris scissors, micro-serrated scissors, a razor blade, specialized nerve microscissors, or a specialized nerve-cutting device. The number of years in practice ( = 0.0271) and the percentage of practice that involves treating patients with peripheral nerve injuries ( = 0.0054) is significantly associated with the belief that crushing the donor nerves during transection may result in worse outcomes following nerve transfer. Only the latter is significantly associated with this belief in recipient nerves ( = 0.0214).
Our findings demonstrate that peripheral nerve surgeons believe that the technique used to transect nerves before coaptation influences outcomes after nerve transfer. Further ex vivo studies are necessary to investigate how different cutting techniques influence nerve morphology and scarring at the coaptation site to optimize outcomes after peripheral nerve surgery.
对于近端神经损伤患者，会进行神经移植手术以优化其功能恢复潜力。本研究旨在确定周围神经外科医生在神经移植手术中切断神经时所偏好的手术技术和工具。
邀请美国周围神经学会的所有现任成员完成一项包含10个问题的横断面调查。收集有关实践人口统计学、所使用的神经切断器械/技术，以及他们对这是否会影响患者预后的看法的数据。
共有49名美国周围神经学会成员参与了该研究，其中大多数人从事该领域工作超过10年（n = 30/49；61%）。最常见的回答是手术刀刀片（n = 26/49；53%），其余47%使用虹膜剪、显微锯齿剪、剃须刀片、专用神经显微剪或专用神经切断装置。从事该领域工作的年限（P = 0.0271）以及治疗周围神经损伤患者的实践比例（P = 0.0054）与认为在切断过程中挤压供体神经可能导致神经移植后预后更差的看法显著相关。只有后者与对受体神经的这种看法显著相关（P = 0.0214）。
我们的研究结果表明，周围神经外科医生认为在神经吻合前切断神经的技术会影响神经移植后的预后。有必要进行进一步的体外研究，以调查不同的切断技术如何影响神经形态和吻合部位的瘢痕形成，从而优化周围神经手术后的预后。
