Page 33 - Read Online

Di Valerio et al. Plast Aesthet Res 2022;9:62 https://dx.doi.org/10.20517/2347-9264.2022.50 Page 7 of 10

Figure 1. PRISMA flow diagram of included studies.

patients undergoing TMR had lower maximal pain and pain intensity, behavior and interference compared
to the standard of care of burying the cut nerve in muscle. Secondary TMR used to treat patients with
established painful neuromas also reported an improvement in their pain compared to their preoperative
baseline. With encouraging outcomes having been reported throughout multiple randomized controlled
trials, TMR is emerging as a leading surgical technique for pain prevention in patients undergoing major
limb amputations and pain management in patients with preexisting amputations.

TMR has proven a useful tool in accentuating myoelectric potential in prosthesis as well as improving pain
outcomes, specifically in regard to PLP and RLP [22,23] . The overall morbidity of PLP and RLP in amputees has
[24]
been reported in several studies with rates as high as 67% and 25%, respectively . This systematic review
serves to specifically identify outcome parameters related to these debilitating sequelae of amputation,
inclusive of diverse etiologies and timing related to index and subsequent procedures. While studies
measure TMR outcomes in a variety of manners, our review underscores PROMIS for its versatility and
inclination to the multifaceted nature of PLP and RLP. Developed by the NIH, The PROMIS explores
person-centered agency using physical, mental, and social facets of one’s health. Researchers involved in
TMR have found this tool particularly relevant in capturing holistically the devastating effects of PLP and
RLP on physical and emotional well-being.