ABSTRACT: Sural nerve grafts have applicability in many facets of reconstructive surgery. A peroneal perforator was chosen as the pedicle of the vascularized sural nerve graft for the nerve gap. Once the donor branch is isolated, it is then divided and made ready for the sural nerve graft. They may also conduct some physical manipulation tests to see if certain movements cause the onset of symptoms. The trick then is to link the two together. You could think that it would make more sense to simply reconnect the two ends of the severed nerve, but this isn't always possible. The nerve is removed via two or three scars on the back of the leg, shown as the dashed lines. . Robotic Laparoscopic Sural Nerve Graft is a procedure that is performed during a prostatectomy in order to restore erectile function to men who have prostate cancer. The sural nerve graft was harvested by the plastic surgery team under direct visualization and via 3 small longitudinal incisions along the path of the nerve; 15-20 cm of graft material was . Identify some interprofessional strategies that will benefit the patient when performing a sural nerve graft procedure. Treating Sural Nerve Issues Treating sural nerve issues begins with a professional diagnosis by a foot specialist. Appointments 866.588.2264 Appointments & Locations Request an Appointment Function The sural nerve, the most common donor nerve, is considered expendable and has been used extensively in other nerve grafting procedures, such as brachial plexus and peripheral nerve injuries. The nerve is comprised of spinal nerve roots from S1 and S2. The sural nerve is located in the calf and provides sensation (feeling) to the lateral side of the foot. I appologize for the long question, however, it's important provide some history. The great auricular nerve is another potential donor for interposition nerve grafting.The great auricular nerve like the sural nerve is a sensory branch and provides no motor function to adjacent muscles. The same chemical is transmitted by the femoral nerve to help us walk. Return to:Facial Paralysis (surgery for facial nerve paralysis weakness)Dr. Douglas Henstrom University of Iowa Facial Plastic and Reconstructive Surgeon, Director of Facial Nerve CenterDr. Other nerves that we use are the one that provides feeling on the forearm by the elbow or even behind the ear. Select Treatment . The sural nerve is the most commonly used nerve for grafting severe nerve defects. A harvesting technique is described which utilizes a tendon stripper introduced through a single distal incision. Surgeons typically use this nerve to replace portions of the cavernous nerves that are removed during a radical prostatectomy. Nerve grafting surgery is sometimes called a nerve transplant because the graft is removed from one location and placed in another. Your doctor will ask about your symptoms and take a closer look at your foot. curred across the sural nerve graft. Treating Sural Nerve Issues. Sural nerve grafting has been shown to be beneficial to patients with sexual dysfunction after prostate cancer surgery . The idea behind the surgery is to restore the supply of the chemical that the erectile nerves in the penis transmit to trigger an erection. This nerve wrap acts to promote regrowth and to prevent recurrence of scar tissue and adhesions. The sural nerve is the preferred graft because it is easily accessible and leaves the patient with few side effects. Questions.
score of the unilateral interposition sural nerve graft group showed an intermediate level of recovery . 3 months old case of wrist injury with features of ulnar nerve, tendon and vessel injury was Operated by dr imteyazur rahmab at ATMC. . . Volume 7, Issue 5, October 2019 , pp. A portion of the sural nerve is harvested from one leg and then anastomosed to the divided ends of the cavernous nerve. Sometimes too much scar tissue has formed. The surgery was completed in Feb. 2009 and I developed horrific electrical shock sensations for after the procecedure and which lasted for months after the surgery. The sural nerve is commonly used as a nerve graft. Damage to the sural nerve results in minimal deficits, and is thus often used for biopsy or grafts. In the posterior calf, the sural nerve emerges from between the two heads of the gastrocnemius muscle and runs with the small saphenous vein inferiorly to curve under the lateral malleolus. What are the benefits of Nerve Graft Surgery? We present a case of post traumatic thermal sciatic nerve injury that was repaired with a sural nerve graft with good outcomes. Subsequently, in 1985, the orthopedic surgery literature described a series of 20 patients who underwent sural nerve harvest with the tendon stripper using two inci- . Another method involves transferring a functioning nerve, such as the intercostal nerve or spinal accessory nerve . Once grafted in, the nerves deliver a chemical to the penile tissues which acts like a natural form of Viagra, dilating blood vessels and causing an erection. stripper several years ago for the purpose of obtaining sural nerve grafts utilizing a simpli ed single-incision method. Techniques to harvest the sural nerve (SN) under endoscopic guidance in infants with brachial plexus birth injury . a. Sural nerve graft. The sural nerve is a sensory nerve of the lower lateral leg and lateral aspect of the foot. Indications for surgery included obstetrical . Lu, Jim Armstrong, Ida K. Fox , Susan E. Mackinnon Department of Surgery Nelson and colleagues (2006) reported on results using genitofemoral nerve grafts in 27 individuals (5 with bilateral grafts) with radical prostatectomy. Anesthesiology . Damage from surgery in the region eg Achilles repair This injury may not cause significant deficit or disability due to overlap of other nerves. #15 blade scalpel #3 Bard-Parker scalpel handle Small Weitlaner self-retaining retractors Nerve grafts are taken from many locations. Following surgery, the patient is given intravenous fluids and usually progresses to a liquid diet within 12 to 24 hours, and a regular diet soon thereafter. The sural nerve innervate lateral & posterior third of leg and lateral aspect of foot & heel, & lateral portion of the ankle.The sural nerve grafts are frequently used as cable grafts. We here present an interesting case with synovial sarcoma of the wrist.An 8 cm of ulnar nerve defect was reconstructed by vascularized, folded sural nerve graft with the peroneal flap, whereas an 8 cm of distal ulna was reconstructed using extracorporeally . With a relatively easy technique, up to 25 cm of nerve graft may be harvested. If you have a particularly severe nerve injury, your doctor may suggest surgery to restore function to critical muscles by transferring tendons from one muscle to another.
b. .
This nerve allograft acts as a scaffold which supports nerve regeneration across the gap. By 1 1/2 years post surgery, the patient recovered complete sensory and motor function. The cross-face nerve graft is a technique used in facial paralysis surgery to bring in nerve stimulation from the non-paralyzed to the paralyzed side of the face. It is similar to the concept of an extension cord. Types of Nerve Grafts . The harvests were performed under tourniquet control using two 2-cm incisions for access at the lateral malleolus and the midcalf. To repair a damaged nerve, a surgeon removes a small part of the sural nerve in the leg and implants this nerve at the site of the repair. Sural Nerve Your sural nerve is just below your skin's surface in the back of your lower leg (calf). Corneal sub-basal nerve plexus that was absent before surgery in all patients except 4 become detectable in all cases (mean CNFL 14.677.92 mm/mm 1 year postoperatively). He did surgery on my left wrist after the conservative treatment didn't fully help and at the same time did a cubital nerve release on my right elbow that instantly stopped the pain I've been having.I HIGHLY recommend Dr. Badia; he's a true expert and an outstanding surgeon. The nerve gap between the two stumps of . The sural nerve (L4-S1) is a cutaneous sensory nerve of the posterolateral calf with cutaneous innervation to the distal one-third of the lower leg. This method provides adequate length of autogenous graft material without significant difficulty or morbidity. Vascularized medial sural cutaneous nerve based on the superficial sural artery: a reliable nerve graft Abstract The sural nerve is nourished by the single superficial sural artery proximally, but distally receives multiple contributions from musculocutaneous and fasciocutaneous perforators of the posterior tibial and peroneal (fibular) arteries. Willem Pondaag.
This procedure involves using nerve grafts taken from the lower legs that bring a new nerve supply to the penis. . Reconstruction was performed with the sural nerve in all cases (median nerve graft length: 8 cm). Sural nerve sensation began to recover at 3 months after surgery, but there were no cases of complete recovery of sural nerve sensation. Sural nerve grafting is performed under general anesthesia. A nerve injury can result in loss of sensation, for some, it can result in pain.
The sural nerve has been described for nerve reconstruction of the maxillofacial region since it provides many advantages. Autologous reversed sural nerve cable grafting is the gold standard method for reconstruction of large nerve gaps in mixed (motor and sensory) major nerve trunks. Any ischemic changes of the skin are a significant contraindication for harvesting this nerve. Publication in "European Urology" .
How is the sural nerve harvested? Those with a level four nerve injury, which involves a nerve graft, repair or transfer are bound to make a full recovery at a slower rate, with an inch a month. Sural Nerve Excision - 2 years post surgery paresthesia. This new approach eliminates the need for a second surgical site, decreases the time of the procedure and is . The sural nerve is then .
There are several nerve graft or nerve transplant options to restore function to the diaphragm. Progress is assessed with the Tinel sign during serial ofce evaluations. One method involves harvesting the sural nerve from the leg and using it to bypass the site or area of the injury in the neck or chest. All was fine. Attention is now focused on the leg where an expendable sensory nerve (sural nerve) is removed through a series of small incisions. Unfortunately, this treatment does have some disadvantages. Background Vascularized nerve grafting is normally associated with a good outcome, but can be difficult to use for nerve reconstruction in patients with long defects of the sciatic nerve . Chronic sural nerve irritation usually presents as posterior leg pain. Policy In conclusion, this study suggests that the combination of pure fibrin surrounding sural nerve gratis is responsible for inducing the extensive neurological recovery induced by either pure fibrin or sural grafts alone. Alternatives to sural nerve grafts in the upper extremity Louis H. Poppler, Kristen Davidge, Johnny C.Y. Having seen dozens and dozens of Doctors and Surgeons over the past ten years, finally found a surgeon who provided me with some solutions to a nerve problem that has plagued me for 10 years. The diagram on the right shows the new path of the nerve into the penis. 3 cases of large defect sciatic nerve reconstruction using the bilateral sural nerves of the lower legs harvested together with the fascia and lesser saphenous vein to form a vascularized flap are reported. Rose MI, et al. As the sural nerve is purely sensory function dysfunction results in only a relatively trivial deficit. We report 3 cases of large defect sciatic nerve reconstruction using the bilateral sural nerves of the lower legs harvested together with the fascia and lesser saphenous vein to form . Functional recovery is determined by the gap length, the site of the reconstruction, the duration of denervation, the surgical graft bed, the quality of the target muscles and the age .
The nerve is identified through either one long incision or a series of small incisions along the back . Surgical treatment of permanent diaphragm paralysis after interscalene nerve block for shoulder surgery. An expendable segment of sensory nerve harvested from the calf (sural nerve graft) or neck (great auricular nerve) is frequently used to bridge the gap (nerve graft). The sural nerve is a common candidate for autologous nerve grafting as it represents a non-critical sensory nerve leaving a relatively small area of sensory deficit after harvest ( Riedl et al., Other options are the medial antebrachial cutaneous nerve, superficial sensory radial nerve, dorsal cutaneous branch of the ulnar nerve, saphenous nerve, or ulnar nerve. To do this Professor Coombs takes a 30 centimetre section of the sural nerve in the lower . The femoral nerves on each leg are "hooked up" through slits in the groin and the sural nerves stitched to them and threaded under the skin to the base of the penis, where they are . It has been reported that repair of the cavernous nerve using sural nerve grafts leads to 40%-60% recovery of erectile function , , . They can harvest the sural nerve through a small incision around the ankle bone. The purposes of this study were to review our experience using nerve autografts in upper extremity nerve reconstruction and develop recommendations for donor selection. Dr. Sural Nerve Graft. First the surgeon has to prepare the broken nerve to do the standard operation procedures. ABSTRACT: Sural nerve grafts have applicability in many facets of reconstructive surgery. Formation of the sural nerve is the result of either anastomosis of the medial sural cutaneous nerve and the sural communicating nerve, or it may be found as a continuation of the lateral sural cutaneous nerve traveling parallel to the . The patient is placed in the supine position. A common nerve used for grafting is the sural nerve, which innervates parts of the lower leg. A commonly used nerve for autotransplantation is the sural nerve in the upper leg. The patient must be kept warm and adequately hydrated, and the surgical site is elevated . 1. . If long nerve grafts are desired to span the entire face and unite the right and left facial nerves (cross face nerve graft) then both sural nerves may be utilized. Indications The sural nerve, which is found in the back of the leg, is a very long nerve that just provides feeling to the side of the foot. In June of 2009, at my request, the Dr. went back into the area to check and make certain the nerve was completely buried and was not sprouting. Plastic surgery is characterized by a wide range of treatments and multiple approaches in all areas of the human body, especially in the treatment of peripheral nerve injuries [].These are of different etiopathogenesis that can cause an endless number of clinical and histopathological presentations [].When approached surgically, the need for nerve grafting to correct some of these disorders is . Kenalog was placed in the area of the nerve graft anastomoses to minimize postoperative inflammation, and a collagen nerve conduit was used to "wrap" both the phrenic nerve and nerve graft to prevent . The nerve originated from S1 and S2 roots. The diagram on the left shows the nerve graft which is moved from the leg to the groin. This method provides adequate length of autogenous graft material without significant difficulty or morbidity. A nerve wrap is then applied around both the phrenic nerve proper and the sural nerve interposition graft. The sural nerve is easily accessible, has several large fascicles, and is the donor nerve most commonly used in peripheral nerve reconstructive surgery. Treating sural nerve issues begins with an accurate diagnosis, and this is best achieved through a physical exam with an orthopedic specialist. This replaces the action of nerves required for erections that have been damaged during prostate surgery. This surgery with Dr. Seruya repairs the ruptured or cut nerve. . Lu, Jim Armstrong, Ida K. Fox , Susan E. Mackinnon Department of Surgery Alternatives to sural nerve grafts in the upper extremity Louis H. Poppler, Kristen Davidge, Johnny C.Y. Our aim was to evaluate subjective outcome in the lower leg after harvesting the sural nerve for grafting nerve defects. Less commonly, the distal sural nerve may have contribution from only the medial sural nerve (13.3% to 53.8%), and from only the lateral sural nerve in rare cases (0 to 16%) (18). Nerve harvesting may be performed under tourniquet control to minimize bleeding during surgery, although this is not mandatory. Willem Pondaag. Advertising on our site helps support our mission. The sural nerve runs down the back of the ankle and along the side of the foot.
score of the unilateral interposition sural nerve graft group showed an intermediate level of recovery . 3 months old case of wrist injury with features of ulnar nerve, tendon and vessel injury was Operated by dr imteyazur rahmab at ATMC. . . Volume 7, Issue 5, October 2019 , pp. A portion of the sural nerve is harvested from one leg and then anastomosed to the divided ends of the cavernous nerve. Sometimes too much scar tissue has formed. The surgery was completed in Feb. 2009 and I developed horrific electrical shock sensations for after the procecedure and which lasted for months after the surgery. The sural nerve is commonly used as a nerve graft. Damage to the sural nerve results in minimal deficits, and is thus often used for biopsy or grafts. In the posterior calf, the sural nerve emerges from between the two heads of the gastrocnemius muscle and runs with the small saphenous vein inferiorly to curve under the lateral malleolus. What are the benefits of Nerve Graft Surgery? We present a case of post traumatic thermal sciatic nerve injury that was repaired with a sural nerve graft with good outcomes. Subsequently, in 1985, the orthopedic surgery literature described a series of 20 patients who underwent sural nerve harvest with the tendon stripper using two inci- . Another method involves transferring a functioning nerve, such as the intercostal nerve or spinal accessory nerve . Once grafted in, the nerves deliver a chemical to the penile tissues which acts like a natural form of Viagra, dilating blood vessels and causing an erection. stripper several years ago for the purpose of obtaining sural nerve grafts utilizing a simpli ed single-incision method. Techniques to harvest the sural nerve (SN) under endoscopic guidance in infants with brachial plexus birth injury . a. Sural nerve graft. The sural nerve is a sensory nerve of the lower lateral leg and lateral aspect of the foot. Indications for surgery included obstetrical . Lu, Jim Armstrong, Ida K. Fox , Susan E. Mackinnon Department of Surgery Nelson and colleagues (2006) reported on results using genitofemoral nerve grafts in 27 individuals (5 with bilateral grafts) with radical prostatectomy. Anesthesiology . Damage from surgery in the region eg Achilles repair This injury may not cause significant deficit or disability due to overlap of other nerves. #15 blade scalpel #3 Bard-Parker scalpel handle Small Weitlaner self-retaining retractors Nerve grafts are taken from many locations. Following surgery, the patient is given intravenous fluids and usually progresses to a liquid diet within 12 to 24 hours, and a regular diet soon thereafter. The sural nerve innervate lateral & posterior third of leg and lateral aspect of foot & heel, & lateral portion of the ankle.The sural nerve grafts are frequently used as cable grafts. We here present an interesting case with synovial sarcoma of the wrist.An 8 cm of ulnar nerve defect was reconstructed by vascularized, folded sural nerve graft with the peroneal flap, whereas an 8 cm of distal ulna was reconstructed using extracorporeally . With a relatively easy technique, up to 25 cm of nerve graft may be harvested. If you have a particularly severe nerve injury, your doctor may suggest surgery to restore function to critical muscles by transferring tendons from one muscle to another.
b. .
This nerve allograft acts as a scaffold which supports nerve regeneration across the gap. By 1 1/2 years post surgery, the patient recovered complete sensory and motor function. The cross-face nerve graft is a technique used in facial paralysis surgery to bring in nerve stimulation from the non-paralyzed to the paralyzed side of the face. It is similar to the concept of an extension cord. Types of Nerve Grafts . The harvests were performed under tourniquet control using two 2-cm incisions for access at the lateral malleolus and the midcalf. To repair a damaged nerve, a surgeon removes a small part of the sural nerve in the leg and implants this nerve at the site of the repair. Sural Nerve Your sural nerve is just below your skin's surface in the back of your lower leg (calf). Corneal sub-basal nerve plexus that was absent before surgery in all patients except 4 become detectable in all cases (mean CNFL 14.677.92 mm/mm 1 year postoperatively). He did surgery on my left wrist after the conservative treatment didn't fully help and at the same time did a cubital nerve release on my right elbow that instantly stopped the pain I've been having.I HIGHLY recommend Dr. Badia; he's a true expert and an outstanding surgeon. The nerve gap between the two stumps of . The sural nerve (L4-S1) is a cutaneous sensory nerve of the posterolateral calf with cutaneous innervation to the distal one-third of the lower leg. This method provides adequate length of autogenous graft material without significant difficulty or morbidity. Vascularized medial sural cutaneous nerve based on the superficial sural artery: a reliable nerve graft Abstract The sural nerve is nourished by the single superficial sural artery proximally, but distally receives multiple contributions from musculocutaneous and fasciocutaneous perforators of the posterior tibial and peroneal (fibular) arteries. Willem Pondaag.
This procedure involves using nerve grafts taken from the lower legs that bring a new nerve supply to the penis. . Reconstruction was performed with the sural nerve in all cases (median nerve graft length: 8 cm). Sural nerve sensation began to recover at 3 months after surgery, but there were no cases of complete recovery of sural nerve sensation. Sural nerve grafting is performed under general anesthesia. A nerve injury can result in loss of sensation, for some, it can result in pain.
The sural nerve has been described for nerve reconstruction of the maxillofacial region since it provides many advantages. Autologous reversed sural nerve cable grafting is the gold standard method for reconstruction of large nerve gaps in mixed (motor and sensory) major nerve trunks. Any ischemic changes of the skin are a significant contraindication for harvesting this nerve. Publication in "European Urology" .
How is the sural nerve harvested? Those with a level four nerve injury, which involves a nerve graft, repair or transfer are bound to make a full recovery at a slower rate, with an inch a month. Sural Nerve Excision - 2 years post surgery paresthesia. This new approach eliminates the need for a second surgical site, decreases the time of the procedure and is . The sural nerve is then .
There are several nerve graft or nerve transplant options to restore function to the diaphragm. Progress is assessed with the Tinel sign during serial ofce evaluations. One method involves harvesting the sural nerve from the leg and using it to bypass the site or area of the injury in the neck or chest. All was fine. Attention is now focused on the leg where an expendable sensory nerve (sural nerve) is removed through a series of small incisions. Unfortunately, this treatment does have some disadvantages. Background Vascularized nerve grafting is normally associated with a good outcome, but can be difficult to use for nerve reconstruction in patients with long defects of the sciatic nerve . Chronic sural nerve irritation usually presents as posterior leg pain. Policy In conclusion, this study suggests that the combination of pure fibrin surrounding sural nerve gratis is responsible for inducing the extensive neurological recovery induced by either pure fibrin or sural grafts alone. Alternatives to sural nerve grafts in the upper extremity Louis H. Poppler, Kristen Davidge, Johnny C.Y. Having seen dozens and dozens of Doctors and Surgeons over the past ten years, finally found a surgeon who provided me with some solutions to a nerve problem that has plagued me for 10 years. The diagram on the right shows the new path of the nerve into the penis. 3 cases of large defect sciatic nerve reconstruction using the bilateral sural nerves of the lower legs harvested together with the fascia and lesser saphenous vein to form a vascularized flap are reported. Rose MI, et al. As the sural nerve is purely sensory function dysfunction results in only a relatively trivial deficit. We report 3 cases of large defect sciatic nerve reconstruction using the bilateral sural nerves of the lower legs harvested together with the fascia and lesser saphenous vein to form . Functional recovery is determined by the gap length, the site of the reconstruction, the duration of denervation, the surgical graft bed, the quality of the target muscles and the age .
The nerve is identified through either one long incision or a series of small incisions along the back . Surgical treatment of permanent diaphragm paralysis after interscalene nerve block for shoulder surgery. An expendable segment of sensory nerve harvested from the calf (sural nerve graft) or neck (great auricular nerve) is frequently used to bridge the gap (nerve graft). The sural nerve is a common candidate for autologous nerve grafting as it represents a non-critical sensory nerve leaving a relatively small area of sensory deficit after harvest ( Riedl et al., Other options are the medial antebrachial cutaneous nerve, superficial sensory radial nerve, dorsal cutaneous branch of the ulnar nerve, saphenous nerve, or ulnar nerve. To do this Professor Coombs takes a 30 centimetre section of the sural nerve in the lower . The femoral nerves on each leg are "hooked up" through slits in the groin and the sural nerves stitched to them and threaded under the skin to the base of the penis, where they are . It has been reported that repair of the cavernous nerve using sural nerve grafts leads to 40%-60% recovery of erectile function , , . They can harvest the sural nerve through a small incision around the ankle bone. The purposes of this study were to review our experience using nerve autografts in upper extremity nerve reconstruction and develop recommendations for donor selection. Dr. Sural Nerve Graft. First the surgeon has to prepare the broken nerve to do the standard operation procedures. ABSTRACT: Sural nerve grafts have applicability in many facets of reconstructive surgery. Formation of the sural nerve is the result of either anastomosis of the medial sural cutaneous nerve and the sural communicating nerve, or it may be found as a continuation of the lateral sural cutaneous nerve traveling parallel to the . The patient is placed in the supine position. A common nerve used for grafting is the sural nerve, which innervates parts of the lower leg. A commonly used nerve for autotransplantation is the sural nerve in the upper leg. The patient must be kept warm and adequately hydrated, and the surgical site is elevated . 1. . If long nerve grafts are desired to span the entire face and unite the right and left facial nerves (cross face nerve graft) then both sural nerves may be utilized. Indications The sural nerve, which is found in the back of the leg, is a very long nerve that just provides feeling to the side of the foot. In June of 2009, at my request, the Dr. went back into the area to check and make certain the nerve was completely buried and was not sprouting. Plastic surgery is characterized by a wide range of treatments and multiple approaches in all areas of the human body, especially in the treatment of peripheral nerve injuries [].These are of different etiopathogenesis that can cause an endless number of clinical and histopathological presentations [].When approached surgically, the need for nerve grafting to correct some of these disorders is . Kenalog was placed in the area of the nerve graft anastomoses to minimize postoperative inflammation, and a collagen nerve conduit was used to "wrap" both the phrenic nerve and nerve graft to prevent . The nerve originated from S1 and S2 roots. The diagram on the left shows the nerve graft which is moved from the leg to the groin. This method provides adequate length of autogenous graft material without significant difficulty or morbidity. A nerve wrap is then applied around both the phrenic nerve proper and the sural nerve interposition graft. The sural nerve is easily accessible, has several large fascicles, and is the donor nerve most commonly used in peripheral nerve reconstructive surgery. Treating sural nerve issues begins with an accurate diagnosis, and this is best achieved through a physical exam with an orthopedic specialist. This replaces the action of nerves required for erections that have been damaged during prostate surgery. This surgery with Dr. Seruya repairs the ruptured or cut nerve. . Lu, Jim Armstrong, Ida K. Fox , Susan E. Mackinnon Department of Surgery Alternatives to sural nerve grafts in the upper extremity Louis H. Poppler, Kristen Davidge, Johnny C.Y. Our aim was to evaluate subjective outcome in the lower leg after harvesting the sural nerve for grafting nerve defects. Less commonly, the distal sural nerve may have contribution from only the medial sural nerve (13.3% to 53.8%), and from only the lateral sural nerve in rare cases (0 to 16%) (18). Nerve harvesting may be performed under tourniquet control to minimize bleeding during surgery, although this is not mandatory. Willem Pondaag. Advertising on our site helps support our mission. The sural nerve runs down the back of the ankle and along the side of the foot.