In 1993 it was reported that sensory nerve axons enter myocutaneous flaps from all sides of the wound bed through empty perineural tubes, suggesting that small flaps (because less tissue must be reinnervated) and old flaps (because the regenerating process should be completed) would have the best sensation. However, sensory recovery is correlated with neither the flap size nor their age. Since all 16 flaps in this study were placed on significantly traumatized limbs, scar formation should hinder sprouting axons from entering the flap; the present study was performed to test this hypothesis. The sensation of 16 myocutaneous flaps (group A) placed in a nontraumatized wound bed was compared to that of patients in a previous study (group B). All 32 flaps were tested for pin-prick, hot, cold, 30-Hz, 256-Hz vibration, constant touch, moving two-point discrimination, and static two-point discrimination. The results were rated as follows: 2 points for a modality being present all over the flap, 1 for its partial or dull presence, and 0 for no sensation. The elapsed time following surgery was 1.10 –5.40 years in group A and 1.50–8.20 years in group B. Patients in group A scored a mean score of 8.0±2.1 points (4–11) and those in group one of B 5.9± 4.8 (0–13). There was a significant correlation between score and flap age in group A but not in group B; there was no correlation in either group between score and the flap size. Our findings suggest that scar formation is detrimental to the capacity for sensory recovery in myocutaneous flaps. Maximum scar tissue excision is recommended, especially since sensory recovery is not less than in large flaps.
European Journal of Plastic Surgery – Springer Journals
Published: Feb 1, 2003
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