Biomaterial Database

Prevention of damage caused by sural nerve withdrawal for nerve grafting. 2002

Giorgio A Brunelli

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

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.

UI	MeSH Term	Description	Entries
D009463	Neuroma	A tumor made up of nerve cells and nerve fibers. (Dorland, 27th ed)	Neuromas
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D004564	Electrocoagulation	Procedures using an electrically heated wire or scalpel to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. It is different from ELECTROSURGERY which is used more for cutting tissue than destroying and in which the patient is part of the electric circuit.	Diathermy, Surgical,Electrocautery,Endocavitary Fulguration,Galvanocautery,Surgical Diathermy,Thermocoagulation,Fulguration, Endocavitary
D000672	Amputation Stumps	The part of a limb or tail following AMPUTATION, SURGICAL that is proximal to the amputated section.	Amputation Stump,Stump, Amputation,Stumps, Amputation
D000818	Animals	Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA.	Animal,Metazoa,Animalia
D013497	Sural Nerve	A branch of the tibial nerve which supplies sensory innervation to parts of the lower leg and foot.	Nerve, Sural,Nerves, Sural,Sural Nerves
D017208	Rats, Wistar	A strain of albino rat developed at the Wistar Institute that has spread widely at other institutions. This has markedly diluted the original strain.	Wistar Rat,Rat, Wistar,Wistar Rats
D051381	Rats	The common name for the genus Rattus.	Rattus,Rats, Laboratory,Rats, Norway,Rattus norvegicus,Laboratory Rat,Laboratory Rats,Norway Rat,Norway Rats,Rat,Rat, Laboratory,Rat, Norway,norvegicus, Rattus