Current Concepts in Lower Extremity Amputation: A Primer for Plastic Surgeons | Journal CME Article-Journal CME Article: Current Concepts in Lower Extremity Amputation: A Primer for Plastic Surgeons v4 of 5

Journal CME Article: Current Concepts in Lower Extremity Amputation: A Primer for Plastic Surgeons v4 of 5

Video Transcription

Now, we're going to use regenerative peripheral nerve interface technique to manage the serral nerves. A portion of the exposed lateral gastroc muscle is now going to be harvested.  Here we're going to harvest a two centimeter by three centimeter segment of muscle in order to provide two, one centimeter by three centimeter muscle grafts to serve as  denervated recipient targets. So these are then divided.  And so here you see one centimeter by three centimeter targets as described by Paul Sederna. So now the two components of the serral nerve are divided back to healthy nerve fascicle  and the proximal portion of the serral nerve is then delivered into the mid portion of the muscle graft. I use 6-0 proline for this purpose.  Additional sutures are used to close the muscle graft over the top of the donor nerve as shown here.  And then we tend to deliver this deep within the, into the inner space between the medial and lateral gastrocnemius muscles in order to bury the RPNI construct.

Video Summary

The video explains the use of a regenerative peripheral nerve interface technique for managing serral nerves. A segment of the lateral gastrocnemius muscle is harvested to create muscle grafts that serve as denervated recipient targets. The serral nerve components are divided and connected to these grafts using 6-0 proline sutures. The muscle graft is closed over the donor nerve and placed deep into the interspace between the medial and lateral gastrocnemius muscles to embed the RPNI construct effectively. This process is informed by techniques described by Paul Sederna.

Keywords

regenerative peripheral nerve interface

serral nerves

muscle grafts

RPNI construct

Paul Sederna