Perineural and intraneural
fibrosis is thought to be the main cause of failure of the many surgical treatments of
neuropathic pain. We have used
Adcon-T/N carbohydrate polymer gel for prevention of perineural
fibrosis in several parts of the body. In this retrospective study, 54 patients who presented with postoperative
neuropathic pain had microsurgical epineural neurolysis and relocation of a terminal
neuroma. In 19 of them, the
carbohydrate gel was applied at the same time. The mean follow-up was four years and the nerve distribution varied. Postoperative improvement in
pain scores (visual analogue scale (VAS) and
neuropathic pain scale inventory (NPSI)), sensitivity, overall improvement and satisfaction were equivalent in the two groups, with
pain relief in about 80% of the patients. There was no significant beneficial effect in the
carbohydrate gel group. Patients treated with this device had a higher
infection rate (21 compared with 0, p = 0.01) and delayed wound healing (31.6 compared with 11.8, p = 0.2). We conclude that good long-term
pain relief is obtained postoperatively independently of the addition of
carbohydrate gel. There was a slight but not significant trend towards profound
pain relief with the gel.