Background: Targeted muscle reinnervation (TMR) was originally developed to enhance prosthetic control in amputees. However, it has also serendipitously demonstrated benefits in reducing phantom pain and neuromas. As a result, it has emerged as a secondary treatment for chronic neuromas in amputees and holds promise for managing neuropathic pain in non-amputee patients, particularly those with neuromas. This review synthesizes the current literature on TMR indications for non-amputee patients, highlighting its potential to address chronic peripheral nerve pain and neuromas beyond its original application in amputation. Methods: A thorough search of the PubMed and Cochrane databases up to January 2024 was conducted following the PRISMA guidelines. Inclusion criteria comprised case series, cohort studies, and randomized controlled trials reporting TMR outcomes in non-amputees. Results: Of 263 articles initially identified, 8 met the inclusion criteria after screening and full-text assessment. The articles were all case series with varied sample sizes and mainly focused on neuroma treatment (n = 6) and neuropathic pain management (n = 2) for both upper and lower extremities. Clinical studies included TMR efficacy for sural nerve neuromas in the lower extremities and hand neuromas, showing pain relief and improved function. Key findings were encouraging, showing successful pain relief, patient satisfaction, and psychosocial improvement, with only rare occurrences of complications such as motor deficits. Conclusions: In non-amputee patients, TMR appears to be a promising option for the surgical management of neuropathic pain, demonstrating favorable patient satisfaction and psychosocial outcomes along with low morbidity rates. Although functional improvements in gait recovery and range of motion are encouraging, further research will be important to confirm and expand upon these findings.

Background: Interest in microgravity is growing in the medical and surgical fields. This literature review aims to synthesize existing evidence on microgravity applications in plastic surgery, focusing on experimental methods, outcomes, and prospects. Methods: All reported articles up to October 2023, including publications and news reports, were screened for inclusion using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The PubMed keywords and Boolean operators were “plastic surgery AND microgravity,” “plastic surgery AND spaceflight,” “wound healing AND microgravity,” “skin aging AND microgravity,” “skin cancer AND microgravity,” and “melanoma AND microgravity.” Results: A total of 201 articles were identified, and 14 studies were included. Plastic surgery procedures can be performed under microgravity, resulting in a delayed wound healing process. Four studies demonstrated that microgravity could reduce skin thickness and modify cell metabolism. In 2 studies, neoplastic melanoma cells have shown behavioral modifications under microgravity with induced apoptosis but increased potential for metastasis. Conclusions: Microgravity represents a unique environment with potential implications in plastic surgery, although further rigorous studies need to be conducted in humans. The anticipated rise and development of spaceflights render the study of biological changes in space an impactful and significant topic.