Reconstructive Plastic Surgery

Nerve Injury

Nerves are essential to transmit sensory and motor information to parts of your body from your brain. Damaged nerves can cause a partial or total loss of sensation, numbness, immobility, pain and weakness.

When a nerve is cut or damaged, it will try and repair itself. How well it will repair will differ and it will never fully recover. When the ends of the nerve aren’t connected, neuroma can occur.  Neuroma is a lump of nerves that is sore when knocked or put under pressure and causes constant discomfort.

Bringing the cut nerve ends together during microsurgery can aid in their recovery and increase the chance of experiencing a level of sensation again.

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Nerve Regeneration Timeframe

The amount of time it takes for your damaged nerve to regenerate will depend on the injury that occurred.

Nerves that are bruised or receive trauma can take approximately six to 12 weeks to recover. Nerves that are cut will only grow back at about 1mm per day, after a month of rest.

Sensory nerves can recover quicker than motor nerves.

When a motor nerve stops receiving impulses for more than 18 to 24 months it dies away and it no longer activates the muscle. The muscle then dies away.

It’s best to receive treatment as soon as possible as your limb can be damaged as it isn’t protected by the sensations transmitted by your nerves. Also, you may not be able to move normally.

While your nerves regenerate, hand therapy or physiotherapy may be needed.

Recovery and Rehabilitation

After nerve damage your nerves will never fully recover, however function should improve.

You will know your nerve is recovering when you start to feel a tingling feeling at the site where the injury occurred. You may also feel light electrical shocks as the nerve fibres grow back. This will persist, but diminish slowly.

Your recovery will depend on:

  • Age – older people heal slower.
  • Type of injury – a cut nerve repairs better than a crushed nerve.
  • Timeframe – damaged nerves will recover faster if they are repaired quickly.
  • Type of repair – recovery time will depend on the type of repair.
  • Nerve type – sensory nerves heal quicker than motor nerves.
  • Other injuries – recovery time can be hindered by surrounding scar tissue from other injuries.
Microsurgery

Notify the RPS team immediately if you experience any of the following symptoms:

  • nausea, vomiting or diarrhoea
  • fever/high temperature – 38°C or higher
  • shortness of breath
  • leakage of blood or fluid after day one of recovery
  • increasing pain around the site
  • increasing redness around incision site
  • heavy bleeding from incision site.
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More information

What else you should know

What are the types of nerve surgery?

Depending on the individual condition, a nerve can be repaired immediately or later.

Immediate nerve repair

Direct nerve repair

Direct nerve repair has the best recovery rates, but your eligibility will depend on the extent of your nerve injury.

During surgery your surgeon will use a microscope or magnifying glass to repair cut nerves with sutures finer than human hair.

Nerve grafting

If part of the nerve is missing, the surgeon may not be able to perform a direct repair. Nerve grafting involves using a piece of nerve from somewhere else in the body, most commonly the forearm or leg. Patients will have a scar and localised numbness in the area where the graft was taken.

Later nerve surgery

Nerve freeing (Neurolysis)

Nerve freeing may be performed if the nerve was repaired, but there is some scar tissue in the area around the nerve that causes you discomfort when you move, or impedes nerve cell regeneration.

During surgery your surgeon will surgically release the scar tissue to decrease discomfort.

Nerve burying

Neuromas can develop after a nerve injury in the hand, causing pain. This usually occurs in areas where nerves can’t be repaired, such as amputated fingers.

Nerve burying involves the surgeon cutting away the neuroma then burying the nerve inside the muscle or bone to reduce sensitivity and pain. The area will become permanently numb.

Nerve grafting

In some cases a nerve may not recover due to neuroma or if the nerves fail to connect properly.

Nerve grafting involves the surgeon trimming the ends until healthy nerves are exposed, then a piece of nerve graft is inserted. Function and sensation is worse after surgery, however it should gradually improve.

Nerve wrapping

Sometimes due to a neuroma a nerve can be constantly tender. Nerve wrapping involves wrapping a fat, a vein or other substance around the nerve to provide cushioning and reduce sensitivity.

 

 

 

 

 

Will my nerve recover completely following surgery?

Damaged nerves never fully recover, but reconstructive plastic surgery can aid in recovery and help improve sensation and function.

 

Are there any risks and complications after nerve repair and nerve surgery?

As with all surgery there are certain risks and complications. They include:

  • Minimal or no improvement.
  • Bleeding – you may need additional surgery.
  • Infection – you will be given antibiotics before your surgery and sometimes post-surgery. Signs of infection include redness, swelling, increased pain and discharge. Occasionally additional surgery may be needed to clean away the infection.
  • Complex regional pain syndrome – treated with pain relief and physiotherapy.
  • Delayed healing.
  • Nerve grafting complications – you’ll have a scar and the donor site will be numb. On rare occasions a lump occurs on the donor site and additional surgery may be required.
  • Stiffness – a therapist can help improve mobility.
  • Scarring.
How will RPS manage my post-operative care?

The RPS team will give you specific advice regarding your individual post-operative recovery. They will advise:

  • where you will go after your surgery
  • what medication you will be given or prescribed
  • what bandages and dressings you will need and when they’ll be removed
  • if you require stitches, when they’ll be removed
  • when you can get back to normal activity and exercise
  • when to book your follow-up care.
Our Canberra specialists

The team at RPS Canberra are committed to providing you with the best possible outcome.

The extensive specialist skills of our surgical team ensure that you are provided with surgical options designed to maximise form and function.

Our surgeons hold an impressive array of academic credentials, extensive professional experience and a personal commitment to patient satisfaction.