Duraku Liron S, Eberlin Kyle R, Moore Amy, Lu Johnny, Chaudhry Tahseen, George Samuel, Burahee Abdus S, Zuidam J Michiel, Bertelli Jayme, Power Dominic M
From the Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, the Netherlands.
Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
Plast Reconstr Surg Glob Open. 2024 Aug 1;12(8):e6017. doi: 10.1097/GOX.0000000000006017. eCollection 2024 Aug.
Surgical innovation has provided new options for the management of complex peripheral nerve injuries, generating renewed interest in this field. Historic literature may be misinterpreted or misquoted, or create dogma, which is perpetuated in teaching, research publications, and clinical practice. The management of peripheral nerve injuries is based on complex decision-making, with potential lifelong ramifications for patients incorrectly receiving an expectant or surgical management plan.
This article includes opinion from expert leaders in the field of peripheral nerve surgery and questions some of the current assumptions and preconceptions around nerve surgery based on clinical evidence. There was extensive debate regarding the contents of the final article, and the different opinions expressed represent the uncertainty in this field and the differing levels of confidence in available published evidence.
Individual practices vary and, therefore, absolute consensus is impossible to achieve. The work is presented as 10 myths which are assessed using both historical and emerging evidence, and areas of uncertainty are discussed.
It is important to learn lessons from the past, and scholars of history bear the task of ensuring references are accurately quoted. Expunging myths will enhance care for patients, focus research efforts, and expand on the surgical possibilities within this specialty.
外科创新为复杂周围神经损伤的治疗提供了新选择,重新引发了该领域的关注。历史文献可能会被误解、误引,或形成教条,在教学、研究出版物及临床实践中延续下去。周围神经损伤的治疗基于复杂的决策,若患者接受了错误的期待治疗或手术治疗方案,可能会对其产生终身影响。
本文纳入了周围神经外科领域专家的观点,并基于临床证据对当前一些关于神经外科的假设和先入之见提出质疑。围绕最终文章的内容展开了广泛讨论,所表达的不同观点代表了该领域的不确定性以及对现有已发表证据的不同置信水平。
个体实践存在差异,因此不可能达成绝对共识。该研究呈现为10个误区,并利用历史证据和新出现的证据进行评估,同时讨论了存在不确定性的领域。
从过去吸取教训很重要,历史学者肩负着确保参考文献被准确引用的任务。消除误区将改善患者护理、聚焦研究工作,并拓展该专业领域内的手术可能性。