Treatment of Painful Nerves in the Abdominal Wall Using Processed Nerve Allografts

Summary: Neuromas can be a debilitating cause of pain and often negatively affect patients' quality of life. One effective method of treatment involves surgical resection of the painful neuroma and use of a processed nerve allograft to repair the injured nerve segment. Giving the nerve "somewhere to go and something to do" has been shown to effectively alleviate pain in upper and lower extremities. We present the first report of this concept to treat a painful neuroma of the abdominal wall that developed following a laparoscopic gastric bypass. The neuroma was excised, and the affected nerve was reconstructed using a processed nerve allograft as an interposition graft, with resolution of pain and gradual return of normal sensation. Patient-reported outcomes were measured using the Patient Reported Outcomes Measurement Information System. Neuroma excision with concurrent interposition grafting using processed nerve allografts may be a promising method of treatment for postsurgical painful neuromas of the trunk. 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), 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. Published online 6 March 2018. Received for publication August 6, 2017; accepted December 13, 2017. Disclosure: The senior author has received compensation from the Axogen company on 2 occasions as a speaker. The Article Processing Charge was paid for by the authors. Gregory A. Dumanian, MD, Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, 675 N. St. Clair St., Suite 19–250, Chicago, IL 60611, E-mail: gdumania@nm.org Copyright © 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.

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