Comparative study between primary versus delayed peripheral nerve repair after various types of injury

Zeineldin, Ashraf A; Mohammed, M. A.; Elhoseny, Abdel Azim Labib

doi:10.4103/1110-2098.155949

Cited by 4 publications

(4 citation statements)

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“…In a study of 66 median and/or ulnar nerve lesions, Dumont and Alnot 26 found that the time from injury to repair was the most significant prognostic factor in functional nerve recovery. Multiple reports in the literature describe the negative implications of delayed repair on sensory and motor outcomes in a variety of injury patterns, with one study indicating the critical window lies within 3 months 3,10,29,30 . Considering the implications of prolonged nervous deficiency, timing is critical for treatment algorithms involving the peripheral nerves 31,32 …”

Section: Delayed Treatment Of Injured Nervesmentioning

confidence: 99%

“…Multiple reports in the literature describe the negative implications of delayed repair on sensory and motor outcomes in a variety of injury patterns, with one study indicating the critical window lies within 3 months. 3,10,29,30 Considering the implications of prolonged nervous deficiency, timing is critical for treatment algorithms involving the peripheral nerves. 31,32…”

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confidence: 99%

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Evidence-Based Approach to Timing of Nerve Surgery

et al. 2021

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Events causing acute stress to the health care system, such as the COVID-19 pandemic, place clinical decisions under increased scrutiny. The priority and timing of surgical procedures are critically evaluated under these conditions, yet the optimal timing of procedures is a key consideration in any clinical setting. There is currently no single article consolidating a large body of current evidence on timing of nerve surgery. MEDLINE and EMBASE databases were systematically reviewed for clinical data on nerve repair and reconstruction to define the current understanding of timing and other factors affecting outcomes. Special attention was given to sensory, mixed/motor, nerve compression syndromes, and nerve pain. The data presented in this review may assist surgeons in making sound, evidence-based clinical decisions regarding timing of nerve surgery.

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Section: Delayed Treatment Of Injured Nervesmentioning

confidence: 99%

mentioning

confidence: 99%

Evidence-Based Approach to Timing of Nerve Surgery

et al. 2021

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“…The most important contributing factor for poor recovery is the chronic denervation of axons distal to the injury site rather than the denervation of the target muscle 7 , 11 . As a consequence, delayed nerve repair in a clinical setting, results in progressive worsening of regeneration and recovery 1 , 3 , 5 .…”

Section: Introductionmentioning

confidence: 99%

“…Despite advances in microsurgical techniques, full recovery is seldom achieved. Repair may be delayed for several weeks or months to allow other soft tissue or orthopedic injuries to be addressed or, in some contexts, to allow the possibility of spontaneous recovery [1][2][3][4][5] . As the time between injury and repair increases, the proportion of patients experiencing a good recovery decreases dramatically 3,5,6 .…”

Section: Introductionmentioning

confidence: 99%

Delay modulates the immune response to nerve repair

et al. 2023

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Effective regeneration after peripheral nerve injury requires macrophage recruitment. We investigated the activation of remodeling pathways within the macrophage population when repair is delayed and identified alteration of key upstream regulators of the inflammatory response. We then targeted one of these regulators, using exogenous IL10 to manipulate the response to injury at the repair site. We demonstrate that this approach alters macrophage polarization, promotes macrophage recruitment, axon extension, neuromuscular junction formation, and increases the number of regenerating motor units reaching their target. We also demonstrate that this approach can rescue the effects of delayed nerve graft.

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Long-term sensibility outcomes of secondary digital nerve reconstruction with sural nerve autografts: a retrospective study

Dębski¹,

Złotorowicz

Noszczyk³

2021

Eur J Trauma Emerg Surg

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Background Recovery of sensibility after digital nerve injury is crucial for restoring normal hand function. We evaluated long-term outcomes of digital nerve reconstruction with autografts. Methods This retrospective study included patients who underwent secondary reconstruction of digital nerves with nerve autografting. Recovery of sensibility was evaluated based on the following: patient self-assessment, two-point discrimination (2PD), and a total sensation score (sum of proprioception, temperature sensation, and sharp/dull discrimination). Mixed models regression was used to study predictors of sensibility outcomes. The predictors analyzed were age, sex, smoking status, number of fingers involved in a patient (as a measure of injury severity), time to reconstruction, and time to follow-up. Results In 61 patients, 174 digital nerves in 126 fingers were reconstructed after an average of 33.1 weeks from injury. The mean follow-up was 6.4 years from reconstruction. The mean graft length was 3.6 cm. Self-rated sensibility in the affected area was very good in 13% of patients, good in 33%, satisfactory in 40%, and poor in 24%. 2PD at 6 mm was present in 17% of patients, at 10 mm in 12%, and at 15 mm in 18% (mean 2PD was 10.8). Proprioception was preserved in 107 (85%) fingers, sensation of temperature was preserved in 99 (75%) of fingers, and sharp/dull discrimination in 88 (70%) fingers. Time from injury to reconstruction was the only significant predictor of the total sensation score. Conclusion Our data indicate that earlier reconstruction is associated with a favorable outcome.

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Comparative study between primary versus delayed peripheral nerve repair after various types of injury

Cited by 4 publications

References 0 publications

Evidence-Based Approach to Timing of Nerve Surgery

Evidence-Based Approach to Timing of Nerve Surgery

Delay modulates the immune response to nerve repair

Long-term sensibility outcomes of secondary digital nerve reconstruction with sural nerve autografts: a retrospective study

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