Reconstructive surgery for phantom and residual limb pain in post-conflict settings

Abstract

Traumatic amputations remain one of the most frequent and disturbing wounds of armed conflict. In this scenario, most amputees develop residual and phantom limb pain, impacting their quality of life. There are several elective surgical procedures available for both conditions, such as neuroma excision followed by nerve reconstruction, nerve relocation, e.g., surgically implanting a transected nerve into a muscle, nerve transfers in cases of associated paralysis, and most recently, regenerative peripheral nerve interface surgery. Whenever possible in the post-conflict phase, a coordinated effort between traveling humanitarian surgeons specializing in reconstructive microsurgery and local healthcare providers is essential for successfully treating phantom and chronic residual limb pain in post-conflict amputees. While providing a detailed logistical framework for global humanitarian missions is beyond the scope of this article, we provide a brief perspective on a topic of utmost importance for reconstructive surgeons worldwide: the high-quality care and treatment of refugees and those whose lives have been impacted by conflict, disaster, or displacement.