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. 2020 Feb;52(1):12-15.
doi: 10.5152/eurasianjmed.2019.19102.

A New Method to Harvest the Sural Nerve Graft

Hakan Cinal  1 , Ensar Zafer Barin  1 , Murat Kara  1 , Harun Karaduman  1 , Ihtisam Zafer Cengiz  1 , Onder Tan  2 , Elif Demirci  3
Affiliations

A New Method to Harvest the Sural Nerve Graft

Hakan Cinal et al. Eurasian J Med. 2020 Feb.

Abstract

Objective: In this study, we developed a novel technique to harvest the sural nerve using the mini incisions and the carpal tunnel dilators.

Materials and methods: 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.

Results: 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.

Conclusion: The method seems safe and has no damage on the nerve graft histopathologically. We believe that this technique may be used in future.

Keywords: carpal tunnel dilatator; harvest; nerve; sural.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
The parameters of histopathologic evaluation that were applied in 11 random patients.
Figure 2
Figure 2
The sural nerve segment underneath the skin was fully and circumferentially released using the carpal tunnel dilators.
Figure 3
Figure 3
The distal end was divided, and the nerve was then pulled out through the proximal incision.
Figure 4
Figure 4
This process was continued until the desired length of the nerve graft was obtained.
Figure 5
Figure 5
The sural nerve graft of 38 cm could be harvested with this technique.
Figure 6
Figure 6
When the lateral branch was encountered, it was divided through supplement mini skin incision to complete the procedure.
See this image and copyright information in PMC

References

    1. Park HD, Kwak HH, Hu KS, et al. Topographic and histologic characteristics of the sural nerve for use in nerve grafting. J Craniofac Surg. 2007;18:1434–8. doi: 10.1097/scs.0b013e3181534a4d. - DOI - PubMed
    1. Riedl O, Koemuercue F, Marker M, et al. Sural nerve harvesting beyond the popliteal region allows a significant gain of donor nerve graft length. Plast Reconstr Surg. 2008;122:798–805. doi: 10.1097/PRS.0b013e318180ed75. - DOI - PubMed
    1. de Moura W, Gilbert A. Surgical anatomy of the sural nerve. J Reconstr Microsurg. 1984;1:31–9. doi: 10.1055/s-2007-1007051. - DOI - PubMed
    1. Coert JH, Dellon AL. Clinical implications of the surgical anatomy of the sural nerve. Plast Reconstr Surg. 1994;94:850–5. doi: 10.1097/00006534-199411000-00016. - DOI - PubMed
    1. Hankin FM, Jaeger SH, Beddings A. Autogenous sural nerve grafts: a harvesting technique. Orthopedics. 1985;8:1160–1. - PubMed

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