Peri-Operative Complications in Patients Undergoing Peripheral Nerve Surgery

Introduction: With increasing indications and volume of patients undergoing peripheral nerve surgery, it becomes imperative that complication rates are monitored. Unlike other reports, this study looked at complication rates in all types of peripheral nerve surgery, developed a complication classification system and defined most common variables associated with failures and complications.

Methods: All peripheral nerve procedures performed by a single surgeon during a consecutive six-year period were retrospectively reviewed by independent reviewers. Complications occurring within the first thirty postoperative days were recorded and classified into minor, intermediate, or major.

Results: 5219 procedures were performed on 1819 patients in all areas of the body (head and neck, trunk, upper and lower extremities). Total complication rate was 2.91%, with a minor complication rate of 2.47%, intermediate complication rate of 0.44%, and major complication rate of 0%. Forty-five patients (2.47%) had minor complications (18 localized wound infections resolved with oral antibiotics, 17 superficial wound dehiscence managed with local wound care, and 10 small seromas that were aspirated in the office setting). None of these patients required a return to the operating room nor did any suffer long-term sequelae from their complications. Intermediate complications (0.44%, requiring a return to the operating room or admission) were experienced by eight patients: hematoma (1), dehiscence (4), seroma (1), deep vein thrombosis (2). All patients recovered well and had no long-term sequelae from their complications.

Conclusions: Present study confirms that peripheral nerve surgery can safely be performed with a very low complication rate, once proper patient selection was made and surgery properly and timely executed. A classification system for complications following peripheral nerve surgery and most common variables associated with failures and complications will be presented.