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The Journal of Cardiovascular Surgery 2019 Mar 27

DOI: 10.23736/S0021-9509.19.10733-1


lingua: Inglese

Management of the sciatic nerve during trans-femoral amputation: a survey of Dutch surgeons

Merle E. DE BRUIJN 1 , Cora H. ARTS 1, Henk van de MEENT 2, Jan P. FRÖLKE 1

1 Department of Surgery, RadboudUMC, Nijmegen, The Netherlands; 2 Department of Rehabilitation, RadboudUMC, Nijmegen, The Netherlands


BACKGROUND: Neuropathic pain often occurs after leg amputation. It is unclear why some patients suffer from pain and others do not. Intra-operative nerve handling might correlate with these pain syndromes. It is unknown which nerve handling techniques are currently used among surgeons and whether a specific technique is related to eliciting these pain syndromes. The aim of this study was to investigate the current surgical sciatic nerve management used among surgeons in the Netherlands.
METHODS: A survey was carried out among Dutch surgeons. Additionally, surgical sciatic nerve management data were obtained from the surgical reports of trans-femoral amputations that were performed in our hospital.
RESULTS: Seventy-eight of the 102 online surveys were returned. Sharp transection without ligation was used most often (41.0%), followed by sharp transection after ligation (30.8%). There were 38 trans-femoral amputations performed in our hospital. Sharp transection after ligation was most often used (55.3%), followed by transection with electrocautery (13.2%).
CONCLUSIONS: All techniques of transecting the sciatic nerve are currently performed by Dutch surgeons. These results provide a solid basis to perform future studies to investigate whether a specific surgical technique is related to post-amputation pain syndromes.

KEY WORDS: Nerve transection - Amputation - Post-amputation limb pain

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