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Pedicle and free flaps for painful nerve
Nilesh M Chaudhari1, John S Gould
1Section of Foot and Ankle, Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL 35205, USA. Nilesh.Chaudhari@ortho.uab.edu
Foot and Ankle Clinics
|May 24, 2011
Summary
Microsurgical tissue transfer can treat chronic painful nerves when other methods fail. This advanced technique involves wrapping nerves with vascularized tissue to potentially salvage them.
Area of Science:
- Neurosurgery
- Microsurgery
- Peripheral Nerve Surgery
Background:
- Chronic painful nerves significantly impact patient quality of life.
- Conventional treatments often fail for severe peripheral nerve pain.
- Microsurgical interventions offer a potential solution for refractory cases.
Purpose of the Study:
- To describe the surgical technique and indications for pedicled or free tissue transfer in treating chronic painful peripheral nerves.
- To highlight the complexity and specialized training required for this advanced procedure.
Main Methods:
- External neurolysis of the affected nerve segment.
- Circumferential wrapping of the nerve with well-vascularized tissues (fascia, subcutaneous fat, omentum, muscle).
- Replacement of hypersensitive cutaneous areas and nerves using similar vascularized tissues.
Main Results:
- Successful salvage of chronic painful peripheral nerves in patients with prior treatment failures.
- Demonstration of the feasibility of using pedicled or free flaps for nerve coverage and reconstruction.
Conclusions:
- Pedicled or free tissue transfer is a viable, albeit complex, surgical option for chronic painful peripheral nerves refractory to conventional treatments.
- This microsurgical approach requires specialized expertise but can offer significant relief and nerve salvage.
