RESUMEN

Upper extremity amputation can lead to significant functional morbidity. The main goals after amputation are to minimize pain and maintain or improve functional status while optimizing the quality of life. Postamputation pain is common and can be addressed with regenerative peripheral nerve interface surgery or targeted muscle reinnervation surgery. Both modalities are effective in treating residual limb pain and phantom limb pain, as well as improving prosthetic use. Differences in surgical technique between the 2 approaches need to be weighed when deciding what strategy may be most appropriate for the patient.

Asunto(s)

Amputación Quirúrgica , Músculo Esquelético , Regeneración Nerviosa , Nervios Periféricos , Extremidad Superior , Humanos , Extremidad Superior/cirugía , Extremidad Superior/inervación , Regeneración Nerviosa/fisiología , Nervios Periféricos/cirugía , Músculo Esquelético/inervación , Músculo Esquelético/cirugía , Transferencia de Nervios/métodos , Miembro Fantasma

RESUMEN

The attainment of microsurgical competency is an important milestone for plastic surgery trainees. Technical skill and a practiced disposition are required to successfully perform microsurgical procedures. Microsurgical skills curricula may foster both proficiency with technical movements and facilitate performance with minimal cognitive burden while using the operating microscope. The microsurgical skills curriculum presented in this article focuses on three fundamental principles: intrinsic muscle strength, accuracy and precision of movement, and supervised practice. Progressive operative entrustment of trainees is earned through successful completion of deliberate microsurgical exercises rather than timed anastomosis trials. The overarching goal of this curriculum is to develop unconscious competence in microsurgery.