Sensory Reinnervation With Subcutaneously Embedded Innervated Flaps: An Experimental Study in Rats.

Area of Science:

• Plastic Surgery
• Regenerative Medicine
• Surgical Innovation

Background:

• Breast reconstruction aims to restore both aesthetic appearance and sensory function for improved quality of life.
• Innervated flaps are established for conventional mastectomy (CM) reconstruction.
• The efficacy of innervated flaps in skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) requires further investigation.

Purpose of the Study:

• To evaluate the potential of innervated flaps in restoring sensation after SSM and NSM.
• To investigate nerve regeneration and sensory reinnervation in a rat model.

Main Methods:

• Rats underwent modified mastectomy procedures with innervated island flaps.
• Flaps were subcutaneously embedded, with skin paddles either fully or partially deepithelialized (NSM and SSM groups, respectively).
• Control group (CM) had flaps returned to their original position. Sensory recovery was assessed via the cutaneous trunci muscle reflex test and immunohistochemistry.

Main Results:

• Sensory reinnervation occurred in both SSM and NSM groups, indicated by the expansion of the mechanonociceptive field.
• New mechanonociceptive fields appeared and expanded in the NSM group starting at postoperative week 4.
• Histological analysis confirmed the presence of regenerated nerve fibers within the flap tissue and surrounding dermis.

Conclusions:

• Subcutaneously embedded innervated island flaps facilitate nerve regeneration and sensory reinnervation.
• These findings suggest that innervated flaps are a viable option for breast reconstruction after SSM and NSM.