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Painful scar neuropathy:principles of diagnosis and treatment

Plastic and Aesthetic Research 2015年第1期2卷 156-164页

作者： Pierluigi Tos Alessandro Crosio pierfrancesco pugliese Roberto Adani Francesca Toia Stefano Artiaco Department of Orthopedics Reconstructive Microsurgery UnitCity of Health and Sciences of TurinTrauma Hospital10100 TorinoItaly Department of Hand Surgery and Microsurgery University Hospital of Verona37126 VeronaItaly Plastic and Reconstructive Surgery Department of SurgicalOncological and Oral SciencesUniversity of Palermo90127 PalermoItaly

Nerve-tissue interactions are *** nerve injuries may involve intraneural and extraneural scar formation and affect nerve gliding planes,sometimes leading to complex clinical *** of these pathological entities involve pain as the main clinical symptom and can be subsumed under the term“painful scar neuropathy”.The authors review the literature on treatment approaches to peripheral nerve scar neuropathy and the outcomes of neurolysis-associated procedures and propose a simple classification and a therapeutic approach to scar *** search retrieved twenty-one papers,twenty of which reported pain reduction or resolution with various *** is no consensus on the best therapeutic approach to neuropathic pain due to scar *** authors report good or excellent results with different techniques,from nerve wrapping with anti-adhesion devices to nerve coverage or wrapping with vascularized *** authors’classification of and therapeutic approach to peripheral nerve scar lesions aims at promoting a logical approach based on the analysis of lesion type(perineural,or endoneural and perineural),pain type(due to traction or external trauma,pain at rest),and number of previous *** need to be informed that multiple procedures may be required,that outcomes may be partial,and that surgery can potentially worsen preoperative *** review found no evidence for the best therapeutic approach to scar neuropathy,but there is consensus on a multidisciplinary approach.

关键词： Complex regional pain syndrome type II painful neuropathy painful scar neuropathy scar neuritis traction neuropathy

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