Abstract

BackgroundCutaneous neuralgia (CN) is a common challenge for surgical consultation. This report describes directed cutaneous neurectomy (DCN) for persistent CN. MethodsFrom 2010 through 2022, DCN was performed 112 times in 100 patients. All had complete temporary relief of CN by outpatient percutaneous proximal blockade. DCN involved a successful proximal blockade with blue dye added to the injectate, and all blue stained tissue was excised. The site of DCN included groin (49 patients), abdomen (38 patients), chest (7 patients), extremity (4 patients), or skull (2 patients). Relief was judged continuous (C), none (N), or temporary (T). ResultsPain relief was C in 82 patients (27 ​± ​20 ​mo), N in 6 patients, and T in 12 patients (22 ​± ​2 ​mo). The presence of microscopic nerve fibers (46 patients) or mesh (42 patients) did not affect outcome. A second DCN was done in two N patients, followed by C relief. A second DCN was done in seven T patients, and a third DCN was done in three T patients after recurrent CN. ConclusionsRefractory CN can usually be successfully treated by DCN.

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