Prevention of damage caused by sural nerve withdrawal for nerve grafting.
Sural nerve withdrawal in peripheral nerve surgery is commonly performed for grafting nerve lesions with gap. Notwithstanding its popular use, this procedure is not entirely without fault as painful neuromas can occur after the withdrawal. We have treated 24 cases of painful neuromas of sural nerve after withdrawal; 11 of which were treated surgically. A safe procedure to cure and to prevent such neuromas is described - the electrical coagulation of the stump of the nerve by slowly increasing the intensity of the current. This procedure has been devised based on the fact that electrically burnt patients do not produce painful neuromas. An experimental histological study performed on rats demonstrated that slow electrical burning of the stump of a severed nerve prevents the formation of intraneural fibrosis which, on the contrary, forms abundantly when the cut nerve is not coagulated.
Brunelli
Giorgio A
GA
Professor of Orthopaedics, Brescia University Medical School, Dott. Giovanni R Brunelli-Hand surgeon Clinica S. Rita Milano, Foundation for Research on Spinal Cord Lesions, Via Galvani 26, 25123 Brescia, Italy. brunell.g@dracmanet.it
D000672:Amputation Stumps / Q000601:surgery; D000818:Animals; D004564:Electrocoagulation / Q000379:methods*; D009463:Neuroma / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D051381:Rats; D017208:Rats, Wistar; D013497:Sural Nerve / Q000473:pathology / Q000601:surgery*