Plastic Surgery Nerve repair

Peripheral Nerve Repair

Objective

In case of nerve injury:

•   Anastomosis of a diseased or injured peripheral nerve.

Position

Supine or prone depending on access to nerve.

Anesthesia

General or local.

Procedure

   1.  For upper or lower extremity procedures, general, regional or local anesthesia is employed.

   2.  Most often a pneumatic tourniquet is utilized.

   3.  The course of the involved nerve is marked on the skin.

   4.  An incision extending beyond the anticipated site of mobilization is made.

   5.  The uninvolved nerve proximal and distal to the site of injury is carefully mobilized prior to dissecting the involved segment.

   6.  Care is taken to avoid injury to the local branches.

   7.  Dissection of the nerve trunk is performed.

   8.  Anastamosis is achieved after fascicles are rotationally aligned and approximated.

   9.  Epineurium is sutured to add stability to the repair.

10.  The wounds are closed.

11.  Splinting is applied as necessary.

Instruments

•   General plastic procedure set 

•   Microinstrumentation (Needle holder, scissors, forceps) 

•   Basin set 

•   Sheet wadding 

•   Esmarch bandage 

•   Blades (2) No. 15 

•   Bulb syringe 

•   Marking pen 

•   Nerve stimulator (llocaton) for example, concept

•   Magnification.

Any questions be sent to drmmkapur@gmail.com

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