PMID- 17993898
OWN - NLM
STAT- MEDLINE
DCOM- 20080219
LR  - 20121115
IS  - 1049-2275 (Print)
IS  - 1049-2275 (Linking)
VI  - 18
IP  - 6
DP  - 2007 Nov
TI  - Could skin retraction incision minimize nerve injury over the iliac crest?
PG  - 1447-50
AB  - The aim of this study is to elucidate the nerve passage over the iliac crest 
      shifted by skin retraction in harvesting iliac bone graft. A total of 44 iliac 
      crests obtained of 22 nonembalmed Korean fresh cadavers were dissected (six males 
      and 16 females; age range, 57-91 years). In A group (22) of "reposed skin," a 
      skin incision was made from the anterior superior iliac spine (ASIS) to the 
      highest level of iliac crest (HLIC). In B group (22) of "medial retraction," skin 
      was tugged medially 1.5 cm and an incision was made from ASIS to HLIC. In A 
      group, the nerve branches were injured in 19 (86.4%) and 15 (68.2%) in B group. 
      Most injured nerves crossed over the iliac crest and at the posterior half site 
      of ASIS to HLIC. The involved nerves were the subcostal nerve, iliohypogastric 
      nerve, and ilioinguinal nerve. Subcostal nerve was less inflicted with injury in 
      B group (one branch, 4.5%) than A group (four branches, 18.2%). P value is 0.151. 
      Iliohypogastric nerve was significantly least injured in B group (three branches, 
      13.6%) compared with A group (10 branches, 45.5%). P value is 0.022. An injuring 
      rate of ilioinguinal nerve was almost the same between A group (13 branches, 
      59.1%) and B group (14 branches, 63.61%). P value is 0.760. In the procedure of 
      harvesting iliac bone graft, it is suggested to make an incision on the skin 
      retracted medially and on the anterior half site of ASIS to HLIC to avert an 
      injury of superficial sensory nerves.
FAU - Hwang, Kun
AU  - Hwang K
AD  - Department of Plastic Surgery and the Center for Advanced Medical Education by 
      BK21 project, Inha University College of Medicine, Incheon, Korea. 
      jokerhg@inha.ac.kr
FAU - Nam, Yong Seok
AU  - Nam YS
FAU - Kim, Dae Joong
AU  - Kim DJ
FAU - Han, Seung Ho
AU  - Han SH
FAU - Hwang, Se Ho
AU  - Hwang SH
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Craniofac Surg
JT  - The Journal of craniofacial surgery
JID - 9010410
MH  - Aged
MH  - Aged, 80 and over
MH  - Bone Transplantation/*adverse effects
MH  - Cadaver
MH  - Dermatologic Surgical Procedures
MH  - Female
MH  - Humans
MH  - Hypogastric Plexus/injuries
MH  - Ilium/injuries/*innervation
MH  - Inguinal Canal/injuries/*innervation
MH  - Male
MH  - Middle Aged
MH  - Spinal Nerves/injuries
MH  - Tissue and Organ Harvesting/*adverse effects
EDAT- 2007/11/13 09:00
MHDA- 2008/02/20 09:00
CRDT- 2007/11/13 09:00
PHST- 2007/11/13 09:00 [pubmed]
PHST- 2008/02/20 09:00 [medline]
PHST- 2007/11/13 09:00 [entrez]
AID - 00001665-200711000-00035 [pii]
AID - 10.1097/scs.0b013e3181539bab [doi]
PST - ppublish
SO  - J Craniofac Surg. 2007 Nov;18(6):1447-50. doi: 10.1097/scs.0b013e3181539bab.