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Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy

BACKGROUND: The sural nerve is the most frequently harvested nerve autograft and is most often biopsied in the workup of peripheral neuropathy. While the complication types associated with these two procedures are well known, their clinical significance is poorly understood and there is a paucity of...

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Autores principales: Ducic, Ivica, Yoon, Joshua, Buncke, Gregory
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7540447/
https://www.ncbi.nlm.nih.gov/pubmed/32277511
http://dx.doi.org/10.1002/micr.30588
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author Ducic, Ivica
Yoon, Joshua
Buncke, Gregory
author_facet Ducic, Ivica
Yoon, Joshua
Buncke, Gregory
author_sort Ducic, Ivica
collection PubMed
description BACKGROUND: The sural nerve is the most frequently harvested nerve autograft and is most often biopsied in the workup of peripheral neuropathy. While the complication types associated with these two procedures are well known, their clinical significance is poorly understood and there is a paucity of data regarding the complication rates. METHODS: Pubmed search identified studies regarding complications after sural nerve harvest and biopsy. The data was grouped into sensory deficits, chronic pain, sensory symptoms, wound infections, wound complications, other postoperative complications, and complications impacting daily life. The incidence of each complication was calculated, and a chi‐square analysis was performed to determine if there were any differences between nerve biopsies and graft harvest with respect to each complication. RESULTS: Twelve studies yielded 478 sural nerve procedures. Sensory deficits occurred at a rate of 92.9%, chronic pain at 19.7%, sensory symptoms at 41.1%, wound infections at 5.7%, noninfectious wound complications at 7.8%, and impact on daily life at 5.0%. The differences in wound infections, sensory symptoms, and impact on daily life between biopsies versus graft excisions were found to reach statistical significance (p < .05). CONCLUSIONS: Sural nerve excisions can cause chronic postoperative donor‐site complications. Given these complications, alternative available mediums for nerve reconstruction should be explored and utilized wherever appropriate. If an alternative medium is unavailable and nerve autograft must be harvested for nerve reconstruction, then patients should be counseled about risks for developing donor site complications that may negatively affect quality of life.
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spelling pubmed-75404472020-10-09 Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy Ducic, Ivica Yoon, Joshua Buncke, Gregory Microsurgery Review Article BACKGROUND: The sural nerve is the most frequently harvested nerve autograft and is most often biopsied in the workup of peripheral neuropathy. While the complication types associated with these two procedures are well known, their clinical significance is poorly understood and there is a paucity of data regarding the complication rates. METHODS: Pubmed search identified studies regarding complications after sural nerve harvest and biopsy. The data was grouped into sensory deficits, chronic pain, sensory symptoms, wound infections, wound complications, other postoperative complications, and complications impacting daily life. The incidence of each complication was calculated, and a chi‐square analysis was performed to determine if there were any differences between nerve biopsies and graft harvest with respect to each complication. RESULTS: Twelve studies yielded 478 sural nerve procedures. Sensory deficits occurred at a rate of 92.9%, chronic pain at 19.7%, sensory symptoms at 41.1%, wound infections at 5.7%, noninfectious wound complications at 7.8%, and impact on daily life at 5.0%. The differences in wound infections, sensory symptoms, and impact on daily life between biopsies versus graft excisions were found to reach statistical significance (p < .05). CONCLUSIONS: Sural nerve excisions can cause chronic postoperative donor‐site complications. Given these complications, alternative available mediums for nerve reconstruction should be explored and utilized wherever appropriate. If an alternative medium is unavailable and nerve autograft must be harvested for nerve reconstruction, then patients should be counseled about risks for developing donor site complications that may negatively affect quality of life. John Wiley & Sons, Inc. 2020-04-10 2020-09 /pmc/articles/PMC7540447/ /pubmed/32277511 http://dx.doi.org/10.1002/micr.30588 Text en © 2020 The Authors. Microsurgery published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Ducic, Ivica
Yoon, Joshua
Buncke, Gregory
Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy
title Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy
title_full Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy
title_fullStr Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy
title_full_unstemmed Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy
title_short Chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy
title_sort chronic postoperative complications and donor site morbidity after sural nerve autograft harvest or biopsy
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7540447/
https://www.ncbi.nlm.nih.gov/pubmed/32277511
http://dx.doi.org/10.1002/micr.30588
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