Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

21. Dermatome Mapping: Preoperative and Postoperative Assessment
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pre- and postoperative evaluations of patients with chronic postoperative
pain. Currently, we are updating the DMC regularly, expanding it, for
example, not only to evaluate the inguinal region but also to consider
thoracic nerves for cases when postoperative pain occurs in the abdominal
region due to injury or entrapment of thoracic nerves during an inguinal
laparoscopic surgery, or when using transfascial sutures, for instance, in
the Rives or laparoscopic techniques. We have also modified the DMC to
include Dr Chen’s contribution of the term “vague” for nonspecific situations,
subjective inconsistencies, or patients simulating pain that had
previously been termed “faking.”
The Dermatome Mapping Test (DMT) results are presented and
sorted according to the author’s classification (DMC), which takes into
account 4 main aspects:
1. Pain location
L : Pain or discomfort is located on the left side
R : Pain or discomfort is located on the right side
C : Pain or discomfort is located on the center
2. Type of pain or denervation discomfort
N : Neuropathic pain that follows the path of a nerve branch or
dermatome
NN : Non-neuropathic pain that does not follow the pattern of a nerve
branch or dermatome
D : Denervation incidental or secondary to neurectomy, manifested by
anesthesia, hypoesthesia, or numbness
3. Source of neuropathic pain or discomfort and denervation symptoms
Source of neuropathic pain or denervation symptoms
1. For the dermatome of the ilioinguinal nerve
2. For dermatome of the iliohypogastric nerve
3. For the dermatome of the genital branch
4. For the dermatome of the femoral branch
5. For the dermatome of the lateral femoral cutaneous nerve
T1 through T12 For each thoracic nerve dermatome
Source of non-neuropathic pain
Those symptoms that do not follow a nerve dermatome
pattern. The following nomenclature for the source of pain or
discomfort is assigned