Commentary on "A new device for nerve approximation in traumatic injuries of extremities" by K.S. Forootan et al.

Commentary on "A new device for nerve approximation in traumatic injuries of extremities" by K.S.... Eur J Plast Surg (2014) 37:503 DOI 10.1007/s00238-014-0986-9 INVITED COMMENTARY Commentary on "A new device for nerve approximation in traumatic injuries of extremities" by K.S. Forootan et al. Jorg Bahm Received: 26 June 2014 /Accepted: 26 June 2014 /Published online: 9 July 2014 Springer-Verlag Berlin Heidelberg 2014 The authors propose a sophisticated device working as a nerve surgeon’s honest trial to improve his surgical repair and a stump approximator and present two retrospective series out of retrospective analysis in two clinical series how functional their huge clinical and surgical experience to share their skill results may improve. and show that good outcomes are possible [1]. We never see those large series of severely injured patients, The reader in European countries might be reluctant, as the and perhaps, we will remain reluctant to fabricate or use such device is aggressive for both stumps and because tension an approximator. But the good results interfere with some should be avoided in primary repair. But who does not re- principles about nerve repair (tension, fiber density); we could member a situation where a little gap of 1 or 2 cm made us address in new research protocols to improve our knowledge wonder if we should really go for a transplant or not try that and perhaps think differently in selected cases. single time to coapt both stumps, once they were dissected more proximally and distally to allow approximation. As the Conflicts of Interest None authors say: if then 8 or 9/0 sutures hold the stumps together, probably the local tension is acceptable. Graft harvesting thus Ethical Standards This manuscript does not contain clinical studies or patient data. might be prevented in these cases and high fascicle density on both sides of the approximated stumps might be the base of a good clinical recovery. Moreover, the authors have a large clinical experience of References nerve injuries in a geographic region where, unfortunately, war injuries were very common in the last decades. In Europe, 1. Forootan KS, Karimi H, Forootan N-SS (2014) A new device for World War I and II stimulated a lot of improvement in nerve nerve approximation in traumatic injuries of extremities. Eur J Plast repair and their work should be considered for what it is: a Surg. doi:10.1007/s00238-014-0975-z J. Bahm (*) Euregio Reconstructive Microsurgery Unit, Franziskushospital, Aachen, Germany e-mail: jorg.bahm@belgacom.net http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Commentary on "A new device for nerve approximation in traumatic injuries of extremities" by K.S. Forootan et al.

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Publisher
Springer Journals
Copyright
Copyright © 2014 by Springer-Verlag Berlin Heidelberg
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-014-0986-9
Publisher site
See Article on Publisher Site

Abstract

Eur J Plast Surg (2014) 37:503 DOI 10.1007/s00238-014-0986-9 INVITED COMMENTARY Commentary on "A new device for nerve approximation in traumatic injuries of extremities" by K.S. Forootan et al. Jorg Bahm Received: 26 June 2014 /Accepted: 26 June 2014 /Published online: 9 July 2014 Springer-Verlag Berlin Heidelberg 2014 The authors propose a sophisticated device working as a nerve surgeon’s honest trial to improve his surgical repair and a stump approximator and present two retrospective series out of retrospective analysis in two clinical series how functional their huge clinical and surgical experience to share their skill results may improve. and show that good outcomes are possible [1]. We never see those large series of severely injured patients, The reader in European countries might be reluctant, as the and perhaps, we will remain reluctant to fabricate or use such device is aggressive for both stumps and because tension an approximator. But the good results interfere with some should be avoided in primary repair. But who does not re- principles about nerve repair (tension, fiber density); we could member a situation where a little gap of 1 or 2 cm made us address in new research protocols to improve our knowledge wonder if we should really go for a transplant or not try that and perhaps think differently in selected cases. single time to coapt both stumps, once they were dissected more proximally and distally to allow approximation. As the Conflicts of Interest None authors say: if then 8 or 9/0 sutures hold the stumps together, probably the local tension is acceptable. Graft harvesting thus Ethical Standards This manuscript does not contain clinical studies or patient data. might be prevented in these cases and high fascicle density on both sides of the approximated stumps might be the base of a good clinical recovery. Moreover, the authors have a large clinical experience of References nerve injuries in a geographic region where, unfortunately, war injuries were very common in the last decades. In Europe, 1. Forootan KS, Karimi H, Forootan N-SS (2014) A new device for World War I and II stimulated a lot of improvement in nerve nerve approximation in traumatic injuries of extremities. Eur J Plast repair and their work should be considered for what it is: a Surg. doi:10.1007/s00238-014-0975-z J. Bahm (*) Euregio Reconstructive Microsurgery Unit, Franziskushospital, Aachen, Germany e-mail: jorg.bahm@belgacom.net

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Sep 1, 2014

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