The following is a summary of “Directed cutaneous neurectomy for cutaneous neuralgia,” published in the SEPTEMBER 2023 issue of Surgery by Lucas, et al.

Cutaneous neuralgia (CN), a condition characterized by persistent and often severe pain along the skin’s nerves, is a common issue that leads to surgical consultation. For a study, researchers sought to detail the use of directed cutaneous neurectomy (DCN) as a treatment for persistent CN.

Between 2010 and 2022, DCN has performed 112 times in 100 patients. Prior to DCN, all patients had experienced temporary relief from CN through outpatient percutaneous proximal blockade. The DCN procedure involved the successful proximal blockade of the affected nerve, with the addition of blue dye to the injectate. All tissue stained blue was surgically excised. The location of DCN varied, including the groin (49 patients), abdomen (38 patients), chest (7 patients), extremities (4 patients), and skull (2 patients). The duration of pain relief was categorized as continuous (C), none (N), or temporary (T).

Out of the 100 patients, 82 experienced continuous pain relief (lasting an average of 27 months), 6 had no relief, and 12 had temporary relief (lasting an average of 22 months). The presence of microscopic nerve fibers (observed in 46 patients) or mesh (seen in 42 patients) did not significantly affect the outcome. In some cases, a second DCN was performed for patients initially categorized as having no or temporary relief. These subsequent procedures resulted in continuous pain relief.

For patients with refractory CN, directed cutaneous neurectomy (DCN) appeared to be an effective treatment option, often providing substantial and lasting pain relief.

Source: americanjournalofsurgery.com/article/S0002-9610(23)00214-3/fulltext