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Primary Regenerative Peripheral Nerve Interfaces Using Devascularized Vastus Lateralis Muscle in Sensate Anterolateral Thigh Flap Donor Sites
Sensate flaps are increasingly used in diverse areas of plastic surgery. Concurrently, modern techniques in neuroma prevention have emerged, such as regenerative peripheral nerve interface (RPNI). Despite increasing use of sensate flaps, the combined use of donor-site neuroma prevention techniques h...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10473292/ https://www.ncbi.nlm.nih.gov/pubmed/37662471 http://dx.doi.org/10.1097/GOX.0000000000005241 |
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author | Isbester, Kelsey A. Ferrin, Peter Krakauer, Kelsi N. Peters, Blair R. |
author_facet | Isbester, Kelsey A. Ferrin, Peter Krakauer, Kelsi N. Peters, Blair R. |
author_sort | Isbester, Kelsey A. |
collection | PubMed |
description | Sensate flaps are increasingly used in diverse areas of plastic surgery. Concurrently, modern techniques in neuroma prevention have emerged, such as regenerative peripheral nerve interface (RPNI). Despite increasing use of sensate flaps, the combined use of donor-site neuroma prevention techniques has yet to be described. We report on the use of primary donor-site RPNI at the time of sensate anterolateral thigh (ALT) reconstructions. In ALT flaps, the vastus lateralis muscle can be segmentally devascularized from perforator dissection. These segments of devascularized vastus lateralis muscle can easily be used and repurposed as the free muscle grafts needed for RPNI, providing a physiologic target for the regenerating neurons. Donor-site neuroma has not been shown to be a significant issue at standard ALT flap donor sites. Sensate ALT flaps involve harvest of the lateral femoral cutaneous nerve and/or additional femoral sensory branches at a more proximal location close to the level of the anterior superior iliac spine, where injury to the lateral femoral cutaneous nerve may be associated with pain. In this series, eight patients underwent senate ALT flaps with the use of primary RPNI at the sensate ALT donor site. At a mean follow-up of 16.3 months (range 5–25 months), there was minimal to no nerve pain and no clinical evidence of donor-site neuroma. As sensate flap reconstructions are increasingly performed in plastic surgery and data on neuroma prevention techniques continue to grow, we propose consideration of their combined use. |
format | Online Article Text |
id | pubmed-10473292 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-104732922023-09-02 Primary Regenerative Peripheral Nerve Interfaces Using Devascularized Vastus Lateralis Muscle in Sensate Anterolateral Thigh Flap Donor Sites Isbester, Kelsey A. Ferrin, Peter Krakauer, Kelsi N. Peters, Blair R. Plast Reconstr Surg Glob Open Peripheral Nerve Sensate flaps are increasingly used in diverse areas of plastic surgery. Concurrently, modern techniques in neuroma prevention have emerged, such as regenerative peripheral nerve interface (RPNI). Despite increasing use of sensate flaps, the combined use of donor-site neuroma prevention techniques has yet to be described. We report on the use of primary donor-site RPNI at the time of sensate anterolateral thigh (ALT) reconstructions. In ALT flaps, the vastus lateralis muscle can be segmentally devascularized from perforator dissection. These segments of devascularized vastus lateralis muscle can easily be used and repurposed as the free muscle grafts needed for RPNI, providing a physiologic target for the regenerating neurons. Donor-site neuroma has not been shown to be a significant issue at standard ALT flap donor sites. Sensate ALT flaps involve harvest of the lateral femoral cutaneous nerve and/or additional femoral sensory branches at a more proximal location close to the level of the anterior superior iliac spine, where injury to the lateral femoral cutaneous nerve may be associated with pain. In this series, eight patients underwent senate ALT flaps with the use of primary RPNI at the sensate ALT donor site. At a mean follow-up of 16.3 months (range 5–25 months), there was minimal to no nerve pain and no clinical evidence of donor-site neuroma. As sensate flap reconstructions are increasingly performed in plastic surgery and data on neuroma prevention techniques continue to grow, we propose consideration of their combined use. Lippincott Williams & Wilkins 2023-09-01 /pmc/articles/PMC10473292/ /pubmed/37662471 http://dx.doi.org/10.1097/GOX.0000000000005241 Text en Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Peripheral Nerve Isbester, Kelsey A. Ferrin, Peter Krakauer, Kelsi N. Peters, Blair R. Primary Regenerative Peripheral Nerve Interfaces Using Devascularized Vastus Lateralis Muscle in Sensate Anterolateral Thigh Flap Donor Sites |
title | Primary Regenerative Peripheral Nerve Interfaces Using Devascularized Vastus Lateralis Muscle in Sensate Anterolateral Thigh Flap Donor Sites |
title_full | Primary Regenerative Peripheral Nerve Interfaces Using Devascularized Vastus Lateralis Muscle in Sensate Anterolateral Thigh Flap Donor Sites |
title_fullStr | Primary Regenerative Peripheral Nerve Interfaces Using Devascularized Vastus Lateralis Muscle in Sensate Anterolateral Thigh Flap Donor Sites |
title_full_unstemmed | Primary Regenerative Peripheral Nerve Interfaces Using Devascularized Vastus Lateralis Muscle in Sensate Anterolateral Thigh Flap Donor Sites |
title_short | Primary Regenerative Peripheral Nerve Interfaces Using Devascularized Vastus Lateralis Muscle in Sensate Anterolateral Thigh Flap Donor Sites |
title_sort | primary regenerative peripheral nerve interfaces using devascularized vastus lateralis muscle in sensate anterolateral thigh flap donor sites |
topic | Peripheral Nerve |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10473292/ https://www.ncbi.nlm.nih.gov/pubmed/37662471 http://dx.doi.org/10.1097/GOX.0000000000005241 |
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