Management of extensive nerve gaps of more than 5 cm by vein graft in three cases
DOI:
https://doi.org/10.18203/2349-2902.isj20202439Keywords:
Nerve gap, Vein graft, Venous tube, Nerve growth in vein conduitAbstract
The aim of this study was to evaluate the effectiveness of use of extensive vein grafts to manage nerve gap repair. The study on peripheral nerve injury has been carried out in this country as well as abroad for many years, but the use of veins as the conduit is more than three decades old and still in evolving phase for standard clinical procedure. Its application is simple and regeneration of nerve is quite satisfactory specially for nerve gap of less than 5 cm. However, the present study was done on extensive nerve gaps of more than 5 cm to 10 cm gaps specially of after long duration of injury to see the results. Inspite of poor results due to extensive nerve gap and treatment tried after long duration of injury, it is quite encouraging to see nerve growth in biopsy of one venous tube and it is great achievement for future study. As of now any vein tube applied for nerve gap of more than five cm is not successful. So successful use of venous tubes is still in infancy for nerve gap of more than 5 cm.
References
Terzis JK, Smith. Principles, practices and techniques of peripheral nerve surgery; 1991.
Ruiz BJ, Monzonis NA, Piqueras A. Invaginated vein graft as nerve conduit: an experimental study. Microsurgery. 1994;15:105-15.
Guda CM, Heijke, Klapper PT, Richard P, Dutrieux. Vein graft conduits versus conventional suturing in peripheral nerve reconstructions. Microsurgery. 1993;14:584-8.
Glorgio A. Bridging nerve defects with combined skeletal muscle and vein conduits. Microsurgery. 1993;14:247-51.
Chiu DT, Strauch B. A prospective clinical evaluation of autogenous vein grafts used as a nerve conduit for distal sensory nerve defects of 3 cm or less. Plast Reconstr Surg. 1990;86:928-34.
Lundborg G, Dahlin LB, Danielsen N. Nerve regeneration in silicone chambers: influence of gap length and of distal stump components. Exp Neurol. 1982;76:361-75.
Siemionow M, Bozkurt M, Zor F. Regeneration and repair of peripheral nerves with different biomaterials: review. Microsurgery. 2010;30:574-88.
Robinson PH. Nerve regeneration through a two ply-biodegradable nerve guide in the rat and the influence of ACTH 4-9, Nerve growth factor. British J Microsurg. 1991;12(6):412-9.
Danielsen N, Varon S. Characterization of neurotrophic activity in the silicone-chamber model for nerve regeneration. J Reconstr Microsurg. 1995;11:231-5.
Dellon AL, Mackinnon SE. An alternative to the classical nerve graft for the management of the short nerve gap. Plast Reconstr Surg. 1988;82:849-56.
Dahlin LB, Lundborg G. Use of tubes in peripheral nerve repair. Neurosurg Clin N Am. 2001;12:341-52.
Deal DN, Griffin JW, Hogan MV. Nerve conduits for nerve repair or reconstruction. J Am Acad Orthop Surg. 2012;20:63-8.
Johnson PJ, Newton P, Hunter DA. Nerve endoneurial microstructure facilitates uniform distribution of regenerative fibers: a post hoc comparison of midgraft nerve fiber densities. J Reconstr Microsurg. 2011;27:83-90.
