Complications with Peripheral Nerve Injury

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Introduction

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Delayed Healing

Peripheral nerve injury can have an impact on healing, and slow down the healing mechanisms of the skin.

Pressure Ulcers

Patients with limited sensation as a result of a peripheral nerve injury are at increased risk of developing pressure ulcers, which can be harder to see on dark skin. A pressure ulcer is a localised injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear.  A pressure sore can develop in a few hours, but the results can last for many months and can cause significant loss of function and impairment. A number of contributing or confounding factors are associated with pressure ulcers; but the significance of these factors is yet to be elucidated. Tissue injury is related to both extrinsic and intrinsic factors.

• Extrinsic factors include pressure, shear, friction, immobility, and moisture.
• Intrinsic factors relate to the condition of the patient, such as sepsis, local infection, decreased autonomic control, altered level of consciousness, increased age, vascular occlusive disease, anaemia, malnutrition, sensory loss, and contracture.

Keeping skin dry, regular position changes and regular skin checks (use a mirror if necessary) will help.

Read more here about the prevention and management of Pressure Ulcers

Neuroma

A non-cancerous thickening of nerve fibres made of non-conducting tissue that stops the signal from being sent along the nerve. Neuromas are a potential, limiting complication of nerve recovery which can cause pain or hypersensitivity; they usually do not develop until at least six weeks post-injury.