64857 Suture of major peripheral nerve, arm or leg, except sciatic; without transposition

Name of the Procedure:

Suture of Major Peripheral Nerve, Arm or Leg, Except Sciatic; Without Transposition

Summary

A surgical procedure to repair a damaged major peripheral nerve in the arm or leg (excluding the sciatic nerve) by stitching it back together without moving it from its original position.

Purpose

This procedure addresses nerve injuries or lacerations that impair function or cause pain. The goal is to restore nerve function, reduce pain, and improve the affected limb's mobility and sensation.

Indications

• Severe nerve injury from trauma.
• Lacerations or cuts involving major peripheral nerves.
• Symptoms like loss of sensation, muscle weakness, or severe pain.
• Patients in good overall health who are likely to benefit from nerve repair.

Preparation

• Fasting for 6-8 hours prior to surgery.
• Discontinuing certain medications as advised by the healthcare provider.
• Preoperative diagnostic tests like nerve conduction studies or imaging (MRI, ultrasound).

Procedure Description

1. Anesthesia: Administering local or general anesthesia to keep the patient comfortable.
2. Incision: Making an incision over the damaged nerve.
3. Exposure: Carefully exposing the nerve by moving aside surrounding tissue.
4. Suturing: Using fine sutures and microscopic techniques to stitch the nerve ends together.
5. Closure: Closing the surgical site with sutures or staples.
6. Dressing: Applying a sterile dressing to the wound.

Tools: Microscope, fine suture materials, surgical instruments.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity of the injury.

Setting

Performed in a hospital or surgical center.

Personnel

• Orthopedic or plastic surgeon specialized in nerve repair.
• Surgical nurses.
• Anesthesiologist.

Risks and Complications

• Infection at the surgical site.
• Nerve damage or failure to restore function.
• Scarring or adhesion formation.
• Anesthesia-related risks.
• Blood clots or bleeding.

Benefits

• Improved nerve function.
• Relief from pain.
• Enhanced mobility and sensation.
• Potentially quicker return to normal activities.

Recovery

• Pain management with medications.
• Immobilization of the affected limb as advised.
• Physical therapy to regain strength and function.
• Follow-up appointments for monitoring nerve recovery.
• Full recovery can take several months depending on the nerve's healing rate.

Alternatives

• Non-surgical options like physical therapy or nerve stimulation.
• Delayed nerve repair or grafting if immediate repair isn't feasible.
• Pros: Non-invasive, less recovery time.
• Cons: May not provide the same level of functional improvement as surgical repair.

Patient Experience

• Minimal to moderate pain managed by analgesics.
• Temporary restrictions on limb use to ensure proper healing.
• Gradual improvement in nerve function over weeks to months.