Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length
CPT4 code
Name of the Procedure:
Nerve Graft (includes obtaining graft), Single Strand, Arm or Leg; More than 4 cm Length Common name: Nerve Graft Surgery
Summary
Nerve graft surgery involves taking a healthy nerve from one part of the body and using it to repair or replace a damaged nerve in the arm or leg. This procedure helps restore sensation and function in the affected area.
Purpose
Addresses: Nerve damage resulting from injury, surgery, or medical conditions. Goals: To restore nerve function, alleviate pain, and improve mobility and sensation in the affected limb.
Indications
Symptoms and conditions: Nerve injury, chronic pain, loss of sensation or motor function in the arm or leg. Patient Criteria: Patients with significant nerve damage that cannot heal on its own.
Preparation
Instructions: Patients may need to fast for several hours before the procedure. Medications might need adjustment. Diagnostics: Electromyography (EMG), nerve conduction studies, and imaging tests like MRI or CT scans might be necessary.
Procedure Description
- Incision: A surgical incision is made near the damaged nerve.
- Graft Harvesting: A healthy nerve strand, typically from the leg or arm, is carefully harvested.
- Repair: The damaged nerve is exposed, and the graft is sutured to bridge the gap.
- Closure: The surgical sites are closed with sutures or staples. Tools/Equipment: Microsurgical instruments, sutures, magnifying loupes/microscope. Anesthesia: Typically performed under general anesthesia.
Duration
The procedure generally takes 2 to 4 hours.
Setting
Usually performed in a hospital or specialized surgical center.
Personnel
Surgeons: A specialized nerve or plastic surgeon. Nurses: Assisting and providing perioperative care. Anesthesiologists: Administering and monitoring anesthesia.
Risks and Complications
Common Risks: Infection, bleeding, scarring. Rare Complications: Graft rejection, incomplete nerve recovery, chronic pain.
Benefits
Expected Benefits: Improved sensation and function in the affected limb, pain reduction. Realization Timeframe: Benefits may be observed within weeks to months post-surgery.
Recovery
Post-care: Keep the surgical area clean and dry, take prescribed medications, physical therapy may be necessary. Recovery Time: Several weeks to months, depending on the extent of the injury and success of the nerve regeneration. Restrictions & Follow-up: Limited use of the affected limb initially; follow-up appointments to monitor healing.
Alternatives
Other Options: Physical therapy alone, nerve decompression surgery, nerve transfer. Pros and Cons: Non-surgical options may have limited effectiveness for severe damage while surgical alternatives might offer different risks and benefits.
Patient Experience
During the Procedure: The patient will be under anesthesia and will not feel pain. After the Procedure: Expect some pain and swelling, which can be managed with medications. Sensation and function improvements will develop gradually.
Comfort measures like keeping the limb elevated and using ice packs can help with pain and swelling during recovery.