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Use of Bernard's diadynamic current in evaluating recovery of pain sensitivity in transplanted microvascular flaps
Authors:Kozarski J  Panajtović Lj  Novaković M  Stosić S  Bojović M
Abstract:
The application of microvascular transfer of tissues provides a single act transplantation of free flaps to any part of the body. Following the operation, free flaps are nerveless. By spreading out of nerves from the recipient region surrounding into the flap tissue, transplanted free flaps become reinervated. The sensitivity of the transferred free flaps is very important in feet, palms, breasts, genitals, face etc. The aim of our research was to use Bernard's diadynamic currents in establishing the time needed for recovery of the transferred flap's pain sensitivity in comparison with the recipient region's surrounding. At the Clinic for Plastic Surgery and Burns and Clinic for Physical Medicine and Rehabilitation of the Military Medical Academy, we used Bernard's-diadynamic current to analyze the recovery of the pain sensitivity in 33 patients with transferred free flaps. The first tests were performed six moths after the free flap transfer and were repeated in the intervals of 6 to 36 months. The pain recovery was tested in 5 cutaneous, 18 myocutaneous and 10 osteocutaneous flaps transplanted to foot-10, lower leg-13 and head-10. Pain sensitivity in the transferred flaps was detected 6 months after the free flaps transfer and was definitely ascertained 12 months after the operation. Current of 10.11 mA was required to reach the pain sensitivity threshold after the first six months and 8.52 mA after 36 months. It is obvious that the pain sensitivity threshold is significantly higher in the transferred free flaps (p < 0.001) than in the donor or recipient regions' surroundings.
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