Article
Donor site morbidity after sural nerve graft harvesting
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Authors
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Kaoru Tada
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
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Tadahiro Nakajima
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
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Mika Nakada
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
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Masashi Matsuta
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
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Daisuke Yamauchi
- Department of Orthopaedic Surgery, Fukui-ken Saiseikai Hospital, Fukui, Japan
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Kazuo Ikeda
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
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Hiroyuki Tsuchiya
- Department of Orthopaedic Surgery, Kanazawa University, Kanazawa, Japan
| Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: At present, autologous nerve graft is considered the best option for peripheral nerve defects. However, sensory disturbance and the pain associated with the harvesting of uninjured nerves are unresolved issues, and reports of donor site morbidity are limited. The purpose of this study was to evaluate donor site morbidity after sural nerve graft harvesting.
Methods: Ninety-one patients underwent autologous nerve graft by harvesting the sural nerve for peripheral nerves defects at our hospital and related facilities. The current address of these patients was determined from the medical records, and 15 patients (10 males, 5 females; mean age at surgery was 47.6 (range, 22-70) years) agreed to participate in a questionnaire-based survey. The time from surgery to the present was 18.5 (range, 1-37) years. The injured nerves included nine mixed nerves, such as the median nerve, and six sensory nerves, such as the digital nerves. The length of the harvested sural nerve was 111 (range, 20-250) mm. Evaluation was carried out using a questionnaire with a 10-point scale. The evaluation items were:
- 1.
- sensory disturbance of the feet immediately after surgery and in the present state (0 = no disturbance, 10 = extreme disturbance),
- 2.
- pain immediately after surgery and in the present state (0 = no pain, 10 = extreme pain),
- 3.
- current functional impairment (0 = no functional impairment, 10 = extreme functional impairment),
- 4.
- recovery of nerve defects (0 = unsatisfied, 10 = completely satisfied), and
- 5.
- satisfaction with autologous nerve graft (0 = unsatisfied, 10 = completely satisfied).
Results and Conclusions: Sensory disturbance improved from 3.0 ± 3.0 (mean ± SD) immediately after surgery to 2.4 ± 2.5 at present, and pain improved from 2.7 ± 3.6 immediately after surgery to 2.4 ± 3.1 at present, but these differences were not significant. The functional impairment score was 1.8 ± 2.9, while the recovery of nerve defects score was 6.9 ± 2.4, and satisfaction with the autologous nerve graft was 6.9 ± 3.2. Satisfaction with the autologous nerve graft and the recovery of nerve defects were strongly correlated (r = 0.88).
Though donor site morbidity after sural nerve graft harvesting persisted for a long time period after the operation, functional impairment was mild. Moreover, satisfaction was strongly correlated with the recovery of nerve defects. Autologous nerve graft was considered to still be a useful method for cases where a good recovery can be expected.
