Prevention and Management of Painful Neuroma

Lewin–Kowalik, Joanna; Marcol, Wiesław; Kotulska, Katarzyna; Mandera, Marek; Klimczak, Andrzej

doi:10.2176/nmc.46.62

Cited by 89 publications

(72 citation statements)

References 45 publications

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“…Such neuromas could be responsible for neuropathic pain that is chronic but often intermittent as shown in human amputees (Lewin-Kowalik et al, 2006;Wolff et al, 2011).…”

Section: Injuries and Other Lesional Indicatorsmentioning

confidence: 99%

Identifying and monitoring pain in farm animals: a review

Prunier

Mounier

Neindre³

et al. 2013

Animal

103

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One important objective for animal welfare is to maintain animals free from pain, injury or disease. Therefore, detecting and evaluating the intensity of animal pain is crucial. As animals cannot directly communicate their feelings, it is necessary to identify sensitive and specific indicators that can be easily used. The aim of the present paper is to review relevant indicators to assess pain in several farm species. The term pain is used for mammals, birds and fish, even though the abilities of the various species to experience the emotional component of pain may be different. Numerous behavioural changes are associated with pain and many of them could be used on farms to assess the degree of pain being experienced by an animal. Pain, as a stressor, is associated with variations in the hypothalamic-pituitary-adrenal axis as well as in the sympathetic and immune systems that can be used to identify the presence of pain rapidly after it started. However, most of these measures need sophisticated equipment for their assessment. Therefore, they are mainly adapted to experimental situations. Injuries and other lesional indicators give information on the sources of pain and are convenient to use in all types of situations. Histopathological analyses can identify sources of pain in experimental studies. When pronounced and/or long lasting, the pain-induced behavioural and physiological changes can decrease production performance. Some indicators are very specific and sensitive to pain, whereas others are more generally related to stressful situations. The latter can be used to indicate that animals are suffering from something, which may be pain. Overall, this literature review shows that several indicators exist to assess pain in mammals, a few in birds and very few in fish. Even if in some cases, a single indicator, usually a behavioural indicator, may be sufficient to detect pain, combining various types of indicators increases sensitivity and specificity of pain assessment. Research is needed to build and validate new indicators and to develop systems of pain assessment adapted to each type of situation and each species.

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“…Such neuromas could be responsible for neuropathic pain that is chronic but often intermittent as shown in human amputees (Lewin-Kowalik et al, 2006;Wolff et al, 2011).…”

Section: Injuries and Other Lesional Indicatorsmentioning

confidence: 99%

Identifying and monitoring pain in farm animals: a review

Prunier

Mounier

Neindre³

et al. 2013

Animal

103

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“…Neuromas are caused by irritation of nerve fibers following transection or scar formation due to inflammation, fibrosis, and foreign body reaction (FBR). [1][2][3][4] FBR and fibrosis have been found to interrupt the continuity of the axon and thus deflect the growth of the proximal regenerating axon. 5 If the regenerating axon sprouts do not reach and elongate through the trophic distal Schwann cell tube, they will grow in a more random manner and can form a neuroma.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 Neuromas are painful and can reduce patients' quality of life, the usual management of neuromas is neurotomy to dampen excitability in the neuroma. 4 This can be gained either pharmacologically, i.e. injection of local anaesthetics directly into the neuroma or surgically by excision of the neuroma.…”

Section: Introductionmentioning

confidence: 99%

First investigation of spider silk as a braided microsurgical suture

et al. 2011

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Inhibition of axonal outgrowth accompanied by neuroma formation appears in microsurgical nerve repair as reaction to common microsuture materials like silk, nylon, or polyglycolic acid. In contrast, recent findings revealed advantages of spider silk fibers in guiding Schwann cells in nerve regeneration. Here, we asked if we could braid microsutures from native spider silk fibers. Microsutures braided of native spider dragline silk were manufactured, containing either 2 × 15 or 3 × 10 single fibres strands. Morphologic appearance was studied and tensile strength and stress-strain ratio (SSR) were calculated. The constructed spider silk sutures showed a median thickness of 25 μm, matching the USP definition of 10-0. Maximum load and tensile strength for both spider silk microsutures were significantly more than 2-fold higher than for nylon suture; SSR was 1.5-fold higher. All values except elasticity were higher in 3 × 10 strand sutures compared to 2 × 15 strand sutures, but not significantly. In this pilot study, we demonstrate the successful manufacture of microsutures from spider silk. With regards to the mechanical properties, these sutures were superior to nylon sutures. As spider silk displays high biocompatibility in nerve regeneration, its usage in microsurgical nerve repair should be considered.

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“…Segments N1 and N4 were sectioned longitudinally to confirm neuroma formation on the end and the non-fiber growth in the direction of the cranial tibial muscle 39 , confirming the non occurrence of motor contamination.…”

Section: Discussionmentioning

confidence: 97%

Muscle reinnervation in one or two stages?: experimental study in rats with end-to-side nerve graft

et al. 2012

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PURPOSE: To compare muscle reinnervation in one and two surgical stages using end-to-side neurorrhaphy (ESN) without donor nerve injury. METHODS: The experiment was performed on four groups of 20 rats. Group 1 (G1), one stage, received the graft which was sutured to the tibial nerve, with ESN, and its free stump was sutured end-to-end to the distal stump of the sectioned peroneal nerve (PN), all in the same operation. In Group 2 (G2), two stages, the nerve graft was sutured to the tibial nerve, with ESN. Two months later the PN was sectioned and its distal stump connected to the distal stump of the graft as in G1. Normal control group (Gn) received the graft only sutured to the tibial nerve, with ESN. Denervated control group (Gd), as well received the graft and had the PN sectioned and its two stumps buried in adjacent musculature, with the aim of denervating the cranial tibial muscle (CTM), the target of this study. The parameters used to evaluate CTM reinnervation were muscle mass, muscle fiber's minimum diameter and area. RESULTS: The mean CTM mass, the average of the muscular fibers areas and the average of the muscular fiber minimum diameters was higher (all p<0.0001) in G2 than in G1. Comparing the four groups, these parameters had their maximum expression in Gn and the minimum in Gd, as expected. CONCLUSION: The two stages showed better muscle reinnervation than one stage.

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Prevention and Management of Painful Neuroma

Cited by 89 publications

References 45 publications

Identifying and monitoring pain in farm animals: a review

Identifying and monitoring pain in farm animals: a review

First investigation of spider silk as a braided microsurgical suture

Muscle reinnervation in one or two stages?: experimental study in rats with end-to-side nerve graft

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