Abstract
Background Sural nerve has the favorite length and size for nerve graft interposition. Here
two techniques, that is, “stocking seam” and “stair-step” or “stepladder,” have been
used for harvesting sural nerve. The first technique results in an unsightly scar
at the posterior calf, and the latter one takes a long time to perform and exert undue
traction to the graft during harvesting. The purpose of this article is to describe
our experience in harvesting the sural nerve by a nerve stripper.
Patients and Methods A nerve stripper was used for harvesting sural nerve in 35 adult patients (in 6 patients,
sural harvesting was done bilaterally), 27 men and 8 women. Thirty-one sural nerve
harvests were done by closed technique (i.e., harvesting of sural nerve only by two
incisions, one in the posterior of the lateral malleolus and the other in popliteal
fossa), in 8 others by limited open technique, and in 2 cases, there was early laceration
of the sural nerve at the beginning of the study. The contralateral sural nerve was
harvested in one patient and medial antebrachial nerve in another by open technique.
Results The mean length of the retrieved sural nerve was 34.5 cm in the closed technique
group and 35 cm in the limited open technique group. We detected advancing Tinel's
sign in all nerve stripper-assisted sural nerve harvested group members in both the
closed and limited open groups.
Conclusion Sural nerve harvesting by the nerve stripper is a reliable and simple technique,
and it is applicable as a routine technique. Applying controlled rotatory movements
of the nerve stripper instead of pushing can result in satisfactory harvesting of
the sural nerve without early laceration.
Keywords
sural nerve - nerve stripper - harvesting
