The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.
Innervation of skin grafts over free muscle flaps.
Abstract
Skin grafts regain their sensory innervation from the graft bed by the regeneration of nerve endings. Although some clinical studies report sensory recovery in skin grafts implanted on free muscle flaps, the mechanism of recovery is obscure. The purpose of this study was to investigate nerve regeneration in experimental skin grafts on free muscle flaps to elucidate this phenomenon. Thirty-eight male Sprague-Dawley rats, weighing 450-550 g were used in the study. The rat gracilis muscle flap was the free flap model transferred from one groin to the other using microvascular anastomoses. Full-thickness skin grafts harvested from the abdomen were used to cover the free muscle flaps after transfer. Four study groups were formed: Group I (n = 10): Free muscle flaps were transferred without any nerve anastomosis; Group II (n = 10): Free flaps transferred with the anastomosis of the muscle's motor nerve to a sensory nerve at the recipient site; Group III (n = 10): Free flaps transferred with the anastomosis of the muscle's motor nerve to a motor nerve at the recipient site; Group IV (n = 8): Skin grafts were placed directly on the fascia layer over the medial hindlimb muscles and served as controls. The specimens were harvested for histologic examination after 12 weeks. Histologic examination was performed to visualise regenerating nerve endings using H&E, S100, Luxol Fast Blue and tyrosine hydroxylase staining. The specimens were categorically scored according to the staining pattern of neural structures around pilosebaceous units and statistical comparisons were performed by using paired t-test. Skin grafts in both Group II and Group III markedly received tyrosine hydroxylase at the base of their pilosebaceous units in many of the specimens and functional nerve twigs could also be traced from the muscle layer to the overlying skin graft. In contrast, the skin grafts in Group I did not show any nerve function in the central parts. The overall staining scores of Groups II, III and IV were significantly higher than Group I (P < 0.05; P < 0.001; P < 0.05, respectively). There was no statistically significant difference between other groups. No myelinated nerve fibres could be detected in any of the skin grafts with Luxol Fast Blue technique. It was concluded in the present study that skin grafts over reinnervated free muscle flaps can develop significantly better innervation than skin grafts over non-innervated muscle flaps. However, the activity in skin appendages indicating nerve regeneration may only imply a gross sensation and in the absence of any myelinated nerve fibres transmission of finer sensation cannot be expected in any of the study groups.
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“When using fascial flaps with an overlying skin graft, innervation occurs via a phenomenon known as nerve ingrowth or neurotization.”
From Postoperative Cutaneous Sensory Recovery After Different Surgical Approaches for Microtia and Ear Reconstruction (2025) · cites this paper as [17]
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Reconstruction of the Weight-Bearing Surface of the Foot with Nonneurosensory Free Flaps
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Sensory nerve regeneration and reinnervation in muscle following peripheral nerve injury
Adidharma, W., Khouri, A. N., Lee, J. C., Vanderboll, K., Kung, T. A., Cederna, P. S., & Kemp, S. W. P. (2022) · Muscle & Nerve · doi:10.1002/mus.27661 · Cited by 46
Metadata
- Authors
- Bayramiçli, M., Jackson, I. T., & Herschman, B.
- Affiliations
- Ascension Providence Hospital (US)
- Venue
- British Journal of Plastic Surgery
- Publisher
- Elsevier BV
- Published
- 2000-03
- Volume
- 53
- Issue
- 2
- Pages
- 130-136
- ISSN
- 0007-1226 (ISSN-L)
- OpenAlex
- W2045167476
- Cited by
- 31
- References
- 35
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 1 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 1 · 2017: 1 · 2014: 2 · 2013: 1 · 2012: 1
- FWCI
- 1.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- British Journal of Plastic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Reconstructive Surgery and Microvascular Techniques
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Nerve injury and regeneration
- Health Sciences › Medicine › Transplantation › Organ and Tissue Transplantation Research
- Keywords
- skin grafts, free muscle flap, sensory innervation, nerve regeneration, nerve anastomosis, gracilis flap, tyrosine hydroxylase, pilosebaceous unit, sensory nerve endings, myelinated axons, rat model, microvascular anastomosis, S-100 protein, Luxol fast blue
- MeSH terms
- Animals, Male, Nerve Regeneration, Sensation, Skin, Surgical Flaps, Skin Transplantation, Rats, Sprague-Dawley, Muscle, Skeletal, Rats
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