Semi-occlusive dressing for the treatment of fingertip amputations with exposed bone: quantity and quality of soft-tissue regeneration

Abstract

Nineteen fingertip amputations with exposed bone were treated with a semi-occlusive dressing. The quantity and quality of the regenerated soft tissue was examined. In all 19 fingers there was sufficient uncomplicated healing such that secondary surgical procedures were not needed. At follow-up 6–18 months after the injury, soft tissue thickness around the bone of the distal phalanx measured 6.0 mm (SD 1.6) on the palmar aspect (opposite side 7.0 mm (SD 0.8)) and 4.2 mm (SD 1.7) distally (opposite side 4.5 mm (SD 0.8)). The two-point discrimination was 4 mm (SD 2) (opposite side 3 mm (SD 1)). The skin healed almost without scarring and the dermal ridges reformed. The regeneration of the soft tissue thickness to almost 90% of its former extent is higher than we expected.

Keywords

Amputation fingertip semi-occlusive soft tissue regeneration

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References

De Boer

Collinson

. The use of silver sulphadiazine occlusive dressings for finger-tip injuries. J Bone Joint Surg Br. 1981, 63: 545–7.

Ferguson

O’Kane

. Scar-free healing: from embryonic mechanisms to adult therapeutic intervention. Philos Trans R Soc Lond B Biol Sci. 2004, 359: 839–50.

Goitz

Westkaemper

Tomaino

Sotereanos

. Soft-tissue defects of the digits. Coverage considerations. Hand Clin. 1997, 13: 189–205.

Han

Yang

Farrington

Muneoka

. Digit regeneration is regulated by Msx1 and BMP4 in fetal mice. Development. 2003, 130: 5123–32.

Han

Yang

Lee

Allan

Muneoka

. Development and regeneration of the neonatal digit tip in mice. Dev Biol. 2008, 315: 125–35.

Ishikawa

Ogawa

Soeda

Yoshida

. A new classification of the amputation level for the distal art of the finger. J of Japanese Soc for Surg of the Hand. 1990, pp. 54–62.

Lassner

Becker

Berger

Pallua

. Sensory reconstruction of the fingertip using the bilaterally innervated sensory cross-finger flap. Plast Reconstr Surg. 2002, 109: 988–93.

Louis

Palmer

Burney

. Open treatment of digital tip injuries. JAMA. 1980, 244: 697–8.

Martin

Gonzalez del Pino

. Controversies in the treatment of fingertip amputations. Conservative versus surgical reconstruction. Clin Orthop Relat Res. 1998, 353: 63–73.

10.

Mennen

Wiese

. Fingertip injuries management with semi-occlusive dressing. J Hand Surg Br. 1993, 18: 416–22.

11.

Muneoka

Allan

Yang

Lee

Han

. Mammalian regeneration and regenerative medicine. Birth Defects Res. 2008, 84: 265–80.

12.

Muneuchi

Tamai

Igawa

Kurokawa

Igawa

. The PNB classification for treatment of fingertip injuries: the boundary between conservative treatment and surgical treatment. Ann Plast Surg. 2005, 54: 604–609.

13.

Prommersberger

K-J

van Schoonhoven

Lanz

. Behandlung drittgradiger Fingerkuppenerfrierungen eines Bergsteigers mit Semiokklusionsverbänden. Handchir Mikrochir Plast Chir. 2001, 33: 95–100.

14.

Quell

Neubauer

Wagner

. Die Behandlung von Fingerkuppendefektverletzungen mit einem semiokklusiven Verband. Handchir Mikrochir Plast Chir. 1998, 30: 24–9.

15.

Richter

. Fingerkuppendefekte: Ersetzt der Semiokklu-sivverband die Lappenplastik? Obere Extremität. 2010, 1: 6–13.

16.

Roshan

Grant

. Lessons for adult fingertip regeneration: Glimpses from basic research. J Hand Surg Am. 2012, 37: 1287–90.

17.

Yazar

Aydın

Kurt Yazar

BaŞaran

Güven

. Sensory recovery of the reverse homodigital island flap in fingertip reconstruction: a review of 66 cases. Acta Orthop Traumatol Turc. 2010, 44: 345–51.