Sensory perception and neuroanatomical structures in normal and grafted skin of burn survivors

Nedelec, Bernadette; Hou, Quanzhi; Sohbi, Ismahen; Choinière, Manon; Beauregard, Gilles; Dykes, Robert W.

doi:10.1016/j.burns.2005.06.007

Cited by 68 publications

(64 citation statements)

References 47 publications

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“…In the upper part of the aesthesiometer the pressure difference between two consecutive monofilaments is higher and probably more easily detectable [14]. The mean TPT was significantly higher ( p < 0.001) in the scar group (4.53) than in the healthy controls (3.19), these results are consistent with those of other studies [6,31] and suggest that a lack of pressure perception might persist for several years after burn [3]. This procedure shows merit although a few reflections have to be made.…”

Section: Discussionsupporting

confidence: 95%

“…However, sensory changes do not appear to have been routinely measured as outcomes in burns patients, which is surprising since sensation has been included as one of the core domains for burns outcome assessments [11]. The assessment of sensibility has been investigated since the 1960s but clinimetric properties of assessment tools remain understudied in burn literature [11] and predominantly focussed on correlation between sensation and anatomical properties of (grafted) skin [5,6,12,13].…”

Section: Introductionmentioning

confidence: 97%

“…The modalities of touch, two-point discrimination, warming and vibration are all significantly reduced after burn [4]. The underlying pathophysiology of these impairments in body functions is unclear [5,6]. Destruction of b u r n s x x x ( 2 0 1 5 ) x x x -x x x nerve fibres or nerve receptors, surgical interventions (e.g.…”

Section: Introductionmentioning

confidence: 98%

“…In a study on tactile, thermal and pain sensibility in burned patients the 'ascending descending' procedure was used to determine TPT in 121 subjects with upper limb scars 18 months after burn [5]. Likewise, in another burn study, in which 15 patients with grafted skin (10 months after grafting) were tested to evaluate TPT, this 'ascending descending' procedure was described [6]. Besides in the burn population, this 'ascending descending' procedure was also used in patients with chronic neuropathic pain [17,18].…”

Section: Introductionmentioning

confidence: 99%

“…The aim of this paper was to determine the interrater and intrarater reliability of the SWMT within burn scars and healthy controls using the 'ascending descending' procedure to evaluate TPT as described by various authors [5,6,15,17,18,20]. We used the newly developed guidelines for reporting reliability and agreement studies (GRRAS) as a basis to report this reliability study [21].…”

Section: Introductionmentioning

confidence: 99%

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Interrater and intrarater reliability of the Semmes Weinstein aesthesiometer to assess touch pressure threshold in burn scars

Meirte

Moortgat²,

Truijen

et al. 2015

Burns

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Burn scars are frequently accompanied with sensory deficits often remaining present months or even years after injury. Clinimetric properties of assessment tools remain understudied within burn literature. Tactile sense of touch can be examined with the touch pressure threshold (TPT) method using the Semmes Weinstein monofilament test (SWMT). There is in recent research no consensus on the exact measurement procedure when using the SWMT. The aim of this paper was to determine the interrater and intrarater reliability of TPT within burn scars and healthy controls using the 'ascending descending' measurement procedure. We used the newly developed guidelines for reporting reliability and agreement studies (GRRAS) as a basis to report this reliability study. In total 36 individuals were tested; a healthy control group and a scar group. The interrater reliability was excellent in the scar group (ICC=0.908/SEM=0.21) and fair to good in the control group (ICC=0.731/SEM=0.12). In the scar group intrarater ICC value was excellent (ICC=0.822/SEM=0.33). Within the control group also an excellent intrarater reliability (ICC=0.807/SEM=0.27) was found. In conclusion this study shows that the SWMT with the 'ascending descending' measurement procedure is a feasible and reliable objective measure to evaluate TPT in (older) upper extremities burn scars as well as in healthy skin.

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Section: Discussionsupporting

confidence: 95%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Interrater and intrarater reliability of the Semmes Weinstein aesthesiometer to assess touch pressure threshold in burn scars

Meirte

Moortgat²,

Truijen

et al. 2015

Burns

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Effective inhibition of aromatase inhibitor‐associated bone loss by zoledronic acid in postmenopausal women with early breast cancer receiving adjuvant letrozole

Bundred

Campbell

Davidson

et al. 2008

Cancer

202

123

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Although standard clinical prognostic factors predict outcome in diffuse large B‐cell lymphoma (DLBCL), predicting the outcome of patients might be further refined using biological factors. We tested whether serum cytokines could provide prognostic information in DLBCL patients. Thirty cytokines were measured in pretreatment samples from newly diagnosed DLBCL patients using a multiplex ELISA. Sixty‐nine patients treated with R‐CHOP plus epratuzumab were used in an initial cohort and 185 patients treated with standard R‐CHOP served as a subsequent validation cohort. In the initial cohort, elevated serum interleukin‐10 [IL‐10; hazard ratio (HR) = 6.6, P = 0.022], granulocyte macrophage colony‐stimulating factor (HR = 10.8, P= 0.027) and IP‐10 (interferon‐inducible protein‐10, CXCL10; HR = 3.32, P = 0.015) were associated with event‐free survival (EFS). An identical analysis of the subsequent validation cohort confirmed that elevated serum levels of IP‐10 were strongly associated with a poor EFS (HR = 2.42, P = 0.0007); and also identified interleukin‐8 (IL‐8; HR = 3.40, P = 0.00002) and interleukin‐2 receptor (IL‐2R, CD25; HR = 2.59, P = 0.0012) as significantly associated with prognosis. The prognostic significance of elevated IP‐10 remained significant after adjustment for the International Prognostic Index (EFS − HR 1.99, P = 0.009, overall survival‐HR 1.93, P = 0.021). Elevated pretreatment serum IP‐10 levels are therefore associated with an increased likelihood of disease relapse and an inferior survival in patients with DLBCL. Am. J. Hematol. © 2012 Wiley Periodicals, Inc.

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Direct neurotization of free nipple grafts with cadaveric nerve grafts following mastectomy for gender affirming surgery

Loughran,

Hopkins,

Kidney‐Hilt

et al. 2024

Microsurgery

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BackgroundFree nipple grafting makes sensory recovery challenging. Permanent decreased sensation to touch and temperature in skin‐grafted skin is common. Direct neurotization of the nipple‐areolar complex (NAC) graft has been described. However, quantitative data regarding degree of nipple reinnervation possible is unknown. This study aims to quantify and qualify sensation recovery following nerve coaptation to reinnervate the NAC.MethodsPatients undergoing mastectomy for gender dysphoria from 2020 to 2022 were offered nerve allograft to restore nipple sensation. A lateral intercostal nerve was selected and coapted to allograft which was embedded beneath the nipple graft. Semmes Weinstein testing was used to assess nipple sensation. Assessments were made at visits <1 year and >1 year from surgery. Filaments used represented normal sensation, minor diminished sensation, diminished sensation, loss of protective sensation, and deep pressure sensation only.ResultsA total of 115 patients elected for direct neurotization. Semmes Weinstein testing was limited to 46 patients representing 46 encounters and 92 nipples in the <1 year group and 24 encounters and 48 nipples in the >1 year group. Of the 92 nipples in the <1 year group, 17 (18.5%) noted return of normal sensation and 37 (40.2%) noted minor diminished or diminished sensation, indicating nerve reinnervation. There were 38 (41%) nipples with loss of protective sensation or deep sensation only. There were 48 nipples included in the >1 year group. Of the 48 nipples, 4 (8.3%) noted normal sensation and 30 (62.5%) noted minor diminished or diminished sensation, indicating nerve reinnervation. For the remaining 14 nipples, 14 (29%) noted loss of protective sensation or deep sensation only.ConclusionSensory outcomes in NAC grafts used for reconstruction in patients undergoing double incision mastectomy remain poor. Sensation restoration beyond that expected from full thickness skin grafts can be achieved in the majority of patients with nerve allograft via direct neurotization.

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Sensory perception and neuroanatomical structures in normal and grafted skin of burn survivors

Cited by 68 publications

References 47 publications

Interrater and intrarater reliability of the Semmes Weinstein aesthesiometer to assess touch pressure threshold in burn scars

Interrater and intrarater reliability of the Semmes Weinstein aesthesiometer to assess touch pressure threshold in burn scars

Effective inhibition of aromatase inhibitor‐associated bone loss by zoledronic acid in postmenopausal women with early breast cancer receiving adjuvant letrozole

Direct neurotization of free nipple grafts with cadaveric nerve grafts following mastectomy for gender affirming surgery

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