Multistage microsurgical reconstruction after catastrophic shark attack: Vascularized ulnar nerve grafting for a large segmental sciatic nerve defect.

Jeremy Bishay, Harrison Garrett, Rowan Gillies, David Stewart, Bishoy Soliman

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In one paragraph

Article in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jeremy BishayDepartment of Plastic Surgery, Westmead Private Hospital, 12 Mons Road, Westmead, NSW 2145, Australia.

Harrison GarrettDepartment of Plastic Surgery, Westmead Private Hospital, 12 Mons Road, Westmead, NSW 2145, Australia.

Rowan GilliesDepartment of Plastic Surgery, Royal North Shore Hospital, Reserve Road, St Leonards, NSW 2065, Australia.

David StewartDepartment of Plastic Surgery, Royal North Shore Hospital, Reserve Road, St Leonards, NSW 2065, Australia.

Bishoy SolimanDepartment of Plastic Surgery, Westmead Private Hospital, 12 Mons Road, Westmead, NSW 2145, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We present a 48-year-old woman who sustained life threatening polytrauma from a shark attack in New Caledonia, including posterior trunk and thigh crush-avulsion, bilateral upper-limb amputations and a 16 cm segmental sciatic nerve defect. Staged reconstruction included a free latissimus dorsi (LD) flap to the posterior thigh, a vascularized ulnar nerve graft (VUNG) for sciatic repair, a neurotized anterolateral thigh (ALT) flap for sensate hand coverage, toe-to-thumb transfer and targeted muscle reinnervation (TMR). This approach achieved functional independence and quality of life restoration. This is the first reported use of a VUNG for large segmental sciatic nerve reconstruction.

Indexed as

Functional limb salvageMicrosurgeryPeripheral nerve reconstructionShark attack-related injuries (SARIs)Traumatic nerve injuryVascularized nerve graft

Identifiers

PMID41858430

DOI10.1016/j.jpra.2026.02.016

PMCPMC12996801

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