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      Reparación de defecto de nervio femoral tras iatrogenia Translated title: Femoral nerve defect repair after iatrogenic injury

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          Abstract

          Resumen Las lesiones del nervio femoral, en su mayor parte, son secundarias a iatrogenia tras intervenciones quirúrgicas. Presentamos un caso de lesión del nervio femoral tras extirpación de un tumor retroperitoneal, con una recuperación funcional aceptable después de reparar el defecto nervioso con injertos de nervio sural. El defecto tenía 10 cm y la recuperación obtenida MRC ( Medical Research Council ) fue de 4/5. Consideramos que en estos casos, la reparación precoz es fundamental para obtener un resultado adecuado, incluso en situaciones en la que se necesitan largos injertos nerviosos.

          Translated abstract

          Femoral nerve injuries are mostly secondary to iatrogenic after surgical interventions. We present a case of lesion of the femoral nerve after the removal of a retroperitoneal tumor, with an acceptable functional recovery after repair of the defect with sural nerve grafts. The defect was 10 cm length and the recovery obtained MRC (Medical Research Council) was 4/5. We considerer that early repair is essential to obtain an acceptable result, even in situations of being necessary long nerve grafts.

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          Most cited references13

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          Techniques for nerve grafting.

          H Millesi (2000)
          The nerve graft can be completed using many different techniques. This article elaborates the general principles and many details that can be approached in different ways when dealing with nerve grafting. A review of the reasons for the poor performance of early nerve grafts, as well as the origins of nerve grafts, is included. This article discusses the technical aspects of nerve grafting including free nerve grafting and timing and exposure.
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            Fibrin glue: an alternative technique for nerve coaptation--Part II. Nerve regeneration and histomorphometric assessment.

            The results of nerve repair with fibrin glue and microsuture were evaluated in rat nerve transection models. Ninety Wistar-Furth rat median nerves were exposed, transected, and repaired in an end-to-end fashion with one of four substances/techniques: 1) human fibrin sealant (Quixil); 2) autologous graft and human fibrin sealant (Quixil); 3) bovine fibrin sealant (Tissucol); and 4) nylon microsuture, epineurial technique. Histologic analyses were performed at 3-, 6-, and 9-month postoperative intervals, and factors evaluated included: presence of inflammatory cells (i.e., macrophages and T cells); number of Schwann cells at the repair site; number of blood vessels; fibrosis; axonal regeneration; and fiber alignment. An additional group underwent histologic analysis at 3 weeks following repair with Quixil. Surgical time of repair was also measured. Nerve repairs performed with fibrin sealants produced less inflammatory response and fibrosis, and better axonal regeneration and fiber alignment than nerve repairs performed with microsuture. In addition, the fibrin sealant techniques were quicker and easier to use. The authors conclude that fibrin sealant represents a good alternative technique to microsuture for peripheral-nerve repair.
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              Intrapelvic and thigh-level femoral nerve lesions: management and outcomes in 119 surgically treated cases.

              The authors present a retrospective analysis of 119 surgically treated femoral nerve lesions at intrapelvic and thigh levels seen at the Louisiana State University Health Sciences Center.
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                Author and article information

                Journal
                cpil
                Cirugía Plástica Ibero-Latinoamericana
                Cir. plást. iberolatinoam.
                Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) (Madrid, Madrid, Spain )
                0376-7892
                1989-2055
                December 2018
                : 44
                : 4
                : 431-435
                Affiliations
                [2] orgnameFundación Jiménez Díaz orgdiv1Servicio Cirugía Plástica
                [3] orgnameFundación Jiménez Díaz orgdiv1Servicio Cirugía Plástica
                [1] orgnameHospital de La Princesa
                Article
                S0376-78922018000400015 S0376-7892(18)04400400015
                10.4321/s0376-78922018000400015
                3d2f266e-25dc-413c-a372-304e7c097f89

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 27 October 2018
                : 30 November 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 13, Pages: 5
                Product

                SciELO Spain

                Categories
                Reconstructiva

                Tumor retroperitoneal,Sural nerve,Nervio femoral,Nerve grafts,Nervio sural,Femoral nerve,Injertos nerviosos,Retroperitoneal tumours

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