Use of vein grafts in emergency in peripheral nerve defect.
Peripheral nerve defects represent a frequent lesion in emergency. The vein graft is the alternative to nerve graft in cases where the nerve defect does not allow a direct approximation. Our experience on the use of venous graft has brought about excellent functional results that, together with a simple execution of the methodology, are at the bottom of our study. During the last 6 months we have treated 3 cases of peripheral nerve defect with nerve gap >2 cm; 1 lesion of ulnar nerve, 1 lesion of median nerve treated with vein graft and in 1 case an association of the median and ulnar nerve treated with reversed vein graft. An immediate resolution of the pain was observed in all patients already during the first 36/48 hrs. The clinical and electrophysiological evaluations at 3 and 6 months have demonstrated encouraging data regarding functional reparation and re-innervation. Even in consideration of the limited number of cases, comparison with data related to the autologous nerve graft shows a slightly slower recovery, but certainly overlapping to the classical methodology; moreover, excellent clinical results appear from the use of reversed vein graft. The advantage of vein grafts are multiple. There is an overlapping of the functional recovery, that represents the condition sine qua non of each new surgical experimental procedure. The simplicity of the technical execution and the possibility to cover missing nerves without sensory damage is advantageous both for the patient and for the structure, reducing operating time and related costs.
Monacelli
G
G
Institute of Emergency Care and First Aid, University of Rome La Sapienza, Rome, Italy.
Spagnoli
A M
AM
Cigna
E
E
Cascioli
I
I
D006801:Humans; D008475:Median Nerve / Q000293:injuries / Q000601:surgery; D009416:Nerve Regeneration; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000503:physiopathology / Q000601:surgery*; D014182:Transplantation, Autologous; D014459:Ulnar Nerve / Q000293:injuries / Q000601:surgery; D014680:Veins / Q000637:transplantation*