PhD defence F.V. (Floris) Raasveld

Below is a brief summary of the dissertation

Symptomatic neuromas are a major cause of chronic neuropathic pain following peripheral nerve injuries and amputations, significantly impacting patients' quality of life. Despite their clinical importance, substantial gaps exist in understanding their prevalence, optimal diagnostic methods, and treatment approaches. This thesis provides a comprehensive investigation of contemporary neuroma management, addressing these critical knowledge gaps through systematic research across multiple domains.
This research establishes the burden of neuropathic pain in amputees and develops novel diagnostic tools including a neuroma morphology classification system, neuroma-to-nerve ratio measurements, and pain sketch models for predicting surgical outcomes. The thesis evaluates both traditional surgical techniques and contemporary approaches, with particular focus on Targeted Muscle Reinnervation (TMR) as both a preventive and therapeutic intervention. Standardized protocols for neuroma specimen collection and analysis were established to facilitate translational research linking biological characteristics to clinical outcomes.
The findings provide a comprehensive framework for evidence-based neuroma management, demonstrating that active nerve management strategies like TMR represent a paradigm shift from traditional passive techniques. The integration of standardized assessment protocols, predictive instruments, and translational research methodologies establishes a foundation for precision medicine approaches to neuropathic pain management, with immediate applicability for improving patient outcomes following peripheral nerve injury and amputation.