The use of autogenous veins for microsurgical repair of the sural nerve after nerve biopsy.
OBJECTIVE
This study evaluates the results of an alternative technique developed to minimize the risk of complications associated with sural nerve biopsy for histopathological analysis.


METHODS
Twelve subjects underwent sural nerve biopsy and the defect created in the nerve was bridged by a 50-mm-length segment of the saphenous vein; the control group enrolled 23 patients in whom the entire length of the nerve was harvested to be used as autograft for reconstruction of nerves in the upper limb. Sensory reinnervation was quantified by use of the monofilament test and the static 2-point discrimination test, after a follow-up period of 18 months.


RESULTS
The mean time for recovery of protective sensation was 8.7 months in patients submitted to nerve repair, and 10.3 months in the control group (P > .05). The monofilament test and static 2-point discrimination testing demonstrated a mean value of 3.22 and 8 mm (S3), respectively, in the group who underwent sural nerve repair; and 4.17 and 13 mm (S2), respectively, for the control group (P <.05).


CONCLUSIONS
The use of vein as conduits for the repair of the sural nerve did not shorten the time for sensory recovery at the autonomous zone of the nerve; however, the quality of the reinnervation was considered better than the control group. This study suggests that empty veins could be used as conduits to bridge gaps with a length up to 50 mm in cases of injuries of the sural nerve and, possibly, for injuries of other pure sensory nerves as well.
Flores
Leandro Pretto
LP
Unit of Neurosurgery, Hospital de Base do Distrito Federal Brasília, Distrito Federal, Brazil. leandroprettoflores@hotmail.com
D000293:Adolescent; D000328:Adult; D001706:Biopsy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009416:Nerve Regeneration / Q000502:physiology; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function / Q000502:physiology; D012501:Saphenous Vein / Q000033:anatomy & histology / Q000637:transplantation; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D013497:Sural Nerve / Q000098:blood supply / Q000293:injuries / Q000601:surgery*; D016378:Tissue Transplantation / Q000379:methods*; D014182:Transplantation, Autologous / Q000379:methods; D014680:Veins / Q000033:anatomy & histology / Q000294:innervation / Q000637:transplantation*; D055815:Young Adult