Painful scar neuropathy: principles of diagnosis and treatment

Nerve‐tissue interactions are critical. Peripheral nerve injuries may involve intraneural and scar formation and affect nerve gliding planes, sometimes leading to complex clinical . All of these pathological entities involve pain as the main clinical symptom and be subsumed under the term “painful scar neuropathy”. The authors review the literature on approaches to peripheral nerve scar neuropathy and the outcomes of neurolysis‐associated and propose a simple classification and a therapeutic approach to scar neuropathy. The retrieved twenty-one papers, twenty of which reported pain reduction or resolution with techniques. There is no consensus on the best therapeutic approach to neuropathic pain to scar tethering. Most authors report good or excellent results with different techniques, from wrapping with anti‐adhesion devices to nerve coverage or wrapping with vascularized tissue. authors’ classification of and therapeutic approach to peripheral nerve scar lesions aims at a logical approach based on the analysis of lesion type (perineural, or endoneural and ), pain type (due to traction or external trauma, pain at rest), and number of previous . Patients need to be informed that multiple procedures may be required, that outcomes be partial, and that surgery can potentially worsen preoperative conditions. The review found evidence for the best therapeutic approach to scar neuropathy, but there is consensus on a approach.