Intubating a nerve…

The gold standard in the primary and secondary treatment for a nerve gap reconstruction is still autologous nerve grafting. Over short distances, application of nerve conduits can effectively solve the problems of limited availability of donor tissue, sacrifice of a functional nerve, and possible neuroma formation of autologous nerve grafting. There are a variety of non-absorbable and absorbable nerve conduits. The 21-years old patient was a war victim in Syria and suffered a shooting trauma of the left thigh two years ago. Nerve reconstruction of the sciatic nerve with a giant nerve tube was performed 9 months after the trauma. Due to the young age of the patient we decide to conduct an exploration and possibly autologous nerve transplantation 2 years after primary surgery. Intraoperatively we found an intubation tube used as a non-bioabsorbable nerve tube including no nerval tissue. This case describes probably the largest nerve tube ever but it also reflects the improvisation of war surgeons under limited circumstances in order to provide a satisfactory medical care during war times.