Sequelae following sural nerve biopsy in type 1 diabetic subjects

Abstract

(20 [19] years) and all had neuropathy. Three out of 24 patients developed infection (two superficial and one deep) and one had a postoperative bleeding. Less frequent pain among the patients were reported from one center. About one third or more of the patients still complained of pain, mostly mild, in the biopsy area and paraesthesia in the foot two years after surgery. More than two third of the patients were reluctant to a further biopsy; a crucial information in drug trial planning. Conclusions: Sequelae of a sural nerve biopsy occur in type 1 diabetes. Risk for wound infections should be considered.

Subjective outcome related to donor site morbidity after sural nerve graft harvesting: a survey in 41 patients

“…The subjectively most common symptom, as expected [5] and experienced by over 90% of the present patients, was some degree of sensory loss at the foot most commonly in the skin around the heel (Figure 1), which correspond well with our previous results [4,7-10], where the same questionnaire was used to evaluate sequele after biopsy of the whole sural nerve. Interestingly, the patients experienced that the area of sensory loss in the skin decreased over time.…”

“…Information, regarding the possibility for sensory loss around the heel and lateral foot and that this area may decrease over time as well as information about mild or intermittent allodynia seen in 50% of the patients, should be provided to the patients before harvesting the sural nerve. The experienced pain, both immediately and years after the sural nerve harvesting, was described mostly as mild or none at all, which is consistent with our previous study on symptoms following a sural nerve biopsy in healthy volunteers [10]. Interestingly, there was no need among our patients to presently use potent painkillers.…”

“…Interestingly, the patients experienced that the area of sensory loss in the skin decreased over time. In accordance, healthy subjects also notice a similar phenomenon after a sural nerve biopsy [4,9,10,12]. Previous studies, based on telephone interviews, did not focus on reduction of the sensory loss [6,11].…”

“…Exclusion criteria were reconstruction of the sciatic or tibial nerves on the same side as the sural nerve graft was harvested and follow up less than 14 months. Forty-six patients filled the criteria and were asked to fill out a questionnaire [4,10] to describe symptoms from the leg or the foot where the nerve graft was harvested. The different parameters investigated included gender, age at reconstruction, age at follow up, time since injury, type of injured nerve, cause of injury, type of incision on leg and the patient´s occupation.…”

“…In the autumn of 2011 a questionnaire, used previously, but slightly modified to better fit the present patients, to evaluate residual subjective symptoms following sural nerve biopsies in subjects with or without diabetes [4,10], were sent to the 46 identified patients (Additional file 1). It consists of 14 different questions where the patients have to subjectively evaluate their post-operative symptoms from the lower leg.…”