Presentation of the updated S3 guideline 'Treatment of peripheral nerve injuries'
Nora Dengler (Bad Saarow), M. T. Pedro (Günzburg), C. Heinen (Osnabrück), T. Kretschmer (Klagenfurt / AT), J. Frank (Frankfurt a. M.), C. Dumont (Kassel), P. Pöschl (Sinzing b. Regensburg), Alexander Grimm (Tübingen), D. Schwarz (Heidelberg), S. Tafelski (Berlin), J. Kolbenschlag (Tübingen), Rezvan Ahmadi (Heidelberg), K. Schwerdtfeger (Homburg a. d. Saar), L. Harhaus (Ludwigshafen)
Uncertainty about adequate diagnosis and treatment leads to a wide variation in the quality of care for patients with peripheral nerve injuries. The aim of the AWMF S3 guideline 'Treatment of peripheral nerve injuries' (first published June 20, 2013) is to provide reliable and generally accepted definitions of what is necessary and appropriate in prevention, diagnosis and treatment. The current update of the S3 guideline 'Treatment of peripheral nerve injuries' is being led by 5 specialist medical societies (DGNC, DGPRÄC, DGN, DGKOU and DGH) and coordinated by DGPRÄC and DGNC.
By systematic literature review and consensus in an interdisciplinary panel of experts, seven PICO questions as well as statements and recommendations with explanatory background texts were developed.
Six out of the seven PICO questions were addressed using quantitative systematic literature research. The working group agreed on six statements and 59 recommendations as part of the nominal group process and justified them on the basis of current studies. Significant innovations were implemented in the chapters on epidemiology in the area of war injuries, iatrogenic nerve damage and nerve injuries in children. Diagnostically, the relevance of MR neurography has been taken into account and in the area of therapy, reference has been made to the increasing availability of positive studies on the use of nerve transfers. The existing chapter on pain treatment has been expanded, particularly in the areas of 'neuromas' and "neuromodulation", based on current studies.
The updated version was agreed by the working group, approved by the medical societies and submitted to the AWMF on time. To reduce uncertainties in the diagnosis and treatment of nerve injuries and improve the quality of treatment the guideline will be made publically available on the AWMF website.
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