[Re-establishment of sensory function of flaps by nerve implantation]

Taking the afferent sensory fiber discharges as an indicator, re-establishment of sensation of the abdominal island flap was investigated in rabbits. The flap, being fed by the superficial epigastric artery, was transplanted to the leg, and the saphenous nerve was implanted into it. The restoration of flap sensation was studied neuroelectrophysiologically. It was shown that nerve fiber discharges were detected within the boundary of the flaps, and mainly in the central portion of the flap along the course of the implanted nerve, in the nerve implantation animals. There was definite evidence of re-establishment of tactile, pressure, pain and temperature sensations in the flap, except that the unit discharges evoked by lower threshold stimulation were less than normal. In the flaps without nerve implantation nerve fiber discharge was rare, and pain and temperature sensation discharges could not be recorded. In 8 patients, nerve implantation was done in an attempt to re-establish sensations in the fingers. Altogether, 11 lateral antebrachial cutaneous nerve grafts were implanted to 10 fingers. The longest nerve graft was 9cm, and the shortest 2.5cm. They were implanted under the dermis of the denervated palmar skin of fingers or flaps. The follow-up time was 97-924 days. The results were very satisfactory.