Neural Regeneration Research ›› 2012, Vol. 7 ›› Issue (29): 2279-2285.

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Sensory reinnervation of free flaps in reconstruction of the breast and the upper and lower extremities

Nektarios Sinis1, Androniki Lamia1, Helml Gudrun2, Thomas Schoeller2, Frank Werdin2   

  1. 1 Department of Plastic-, Hand- and Reconstructive Microsurgery, St. Marien Krankenhaus Berlin, Berlin 12249, Germany
    2 Department of Handsurgery, Microsurgery and Reconstructive Surgery of the Breast, Marienhospital Stuttgart,Stuttgart 70199, Baden-Württemberg, Germany
  • Received:2012-05-11 Revised:2012-07-10 Online:2012-10-15 Published:2012-10-15
  • Contact: Nektarios Sinis, Department of Plastic-, Hand- and Reconstructive Microsurgery, St. Marien Krankenhaus Berlin, Gallwitzallee 123-143, Berlin 12249, Germany (please recheck it is correct) sinis@marienkrankenhaus- berlin.de
  • About author:Nektarios Sinis, Department of Plastic-, Hand- and Reconstructive Microsurgery, St. Marien Krankenhaus Berlin, Gallwitzallee 123-143, Berlin 12249, Germany (please recheck it is correct)sinis@marienkrankenhaus- berlin.de

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Abstract:

There is long-standing debate about sensate versus non-sensate free microvascular flaps among microsurgeons. The principle of connecting not only the vascular supply, but also sensitive nerves, in free tissue transfer is attractive. However, increased operating time and partial spontaneous innervation led to the common decision to restrict microsurgical tissue transfer to the vascular anastomosis and to leave the nerves “untreated”. Nevertheless, in special cases such as breast reconstruction or extremity reconstruction, the question about sensory nerve coaptation of the flaps remains open. We present our experience with free microvascular tissue transfer for breast and extremity reconstruction and compare the data with previous literature and conclude that most free flap surgeries do not benefit from nerve coaptation.

Key words: free tissue flap, mammaplasty, dermatoplasty, free tissue transfer flap, free microvascular tissue transfer, breast reconstruction, extremity reconstruction, sensate flap, non-sensate flap