Noaman, A., Abul Halim, I., Elshitany, H., Ahmed, R., Ashraf, M. (2019). Circumferential Vein Wrapping Versus Vein Sheath to Improve the Outcome of Peripheral Nerve Repair. The Egyptian Journal of Plastic and Reconstructive Surgery, 43(1), 55-60. doi: 10.21608/ejprs.2019.65156
Ayman Noaman; Ihab Abul Halim; Hisham Elshitany; Rama Ahmed; Mohamed Ashraf. "Circumferential Vein Wrapping Versus Vein Sheath to Improve the Outcome of Peripheral Nerve Repair". The Egyptian Journal of Plastic and Reconstructive Surgery, 43, 1, 2019, 55-60. doi: 10.21608/ejprs.2019.65156
Noaman, A., Abul Halim, I., Elshitany, H., Ahmed, R., Ashraf, M. (2019). 'Circumferential Vein Wrapping Versus Vein Sheath to Improve the Outcome of Peripheral Nerve Repair', The Egyptian Journal of Plastic and Reconstructive Surgery, 43(1), pp. 55-60. doi: 10.21608/ejprs.2019.65156
Noaman, A., Abul Halim, I., Elshitany, H., Ahmed, R., Ashraf, M. Circumferential Vein Wrapping Versus Vein Sheath to Improve the Outcome of Peripheral Nerve Repair. The Egyptian Journal of Plastic and Reconstructive Surgery, 2019; 43(1): 55-60. doi: 10.21608/ejprs.2019.65156
Circumferential Vein Wrapping Versus Vein Sheath to Improve the Outcome of Peripheral Nerve Repair
1The Departments of Plastic Surgery, Faculty of Medicine, Cairo University
2The Departments of Neurosurgery, Faculty of Medicine, Cairo University
3The Departments of Plastic Surgery* and Neurosurgery**, Faculty of Medicine, Cairo University
Abstract
Background: Trauma to peripheral nerves is relatively common which can be caused by blunt trauma or penetrating injuries. An important quality of the peripheral nervous system, as compared with the central nervous system, is its remarkable ability to recover after an injury. To improve the outcome in post-traumatic peripheral nerve injury beside precise suturing and orientation of the nerve stumps is to protect the anastomosis from the surrounding environment; this barrier should be biologically inert, biodegradable and non-compressive. Vein wrapping to the site of anastomosis was described to protect the neuro-anastomosis and to improve nerve conduction and prevent neuroma formation. Methods: This randomized controlled study was conducted on 60 patients presenting with either median or ulnar nerve injuries in the forearm, they were divided into 3 groups were group (A) The neuro-anastomosis was covered with a vein segment passed through one segment and after the neurorrhaphy the vein is stretched to cover the suture line, In Group < br />(B) The neuro-anastomosis was covered with a vein segment who was circumferentially wrapped, In Group (C) the neuro anastomosis was not covered with a vein wrap. Results: After 12 months follow-up were: Functional recovery of motor nerves, sensitivity and the presence of neuroma at the site of nerve both group A and B showed a more rapid motor and sensory recovery and a reduction of the painful symptoms compared to the control group (C). Conclusion: Both Vein wrapping techniques provides a valid solution to avoid the dispersion of the nerve fibers, adherent scars and painful neuromas formation.
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