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Jester N, Han S, Singh M, Rao AA, Sokhal B, Ma Y, Jester A. Outcomes of Composite Grafts for Pediatric Fingertip Amputations: A Systematic Review. Indian J Plast Surg 2023; 56:310-319. [PMID: 37705815 PMCID: PMC10497336 DOI: 10.1055/s-0043-1771295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Introduction The aim of this study was to explore the outcomes of composite grafts in fingertip amputations in children as well as the contributing factors that may affect outcomes. Methods Literature search was conducted across six databases in March 2022 to select studies on the use of composite grafts on fingertip amputations in the pediatric population. Results Twelve articles with 735 composite grafts were identified for review. Most fingertip injuries occurred in the less than 5-year age group and were due to crush type injuries. In studies that reported "complete" graft take as a separate outcome measure, 17.3% of fingertips with this result were observed. In the studies that reported "complete" and "partial" graft take together as an outcome measure, 81.6% of fingertips achieved this outcome. A lower proportion of failed graft take was observed in more distal fingertip amputations. Infection (3.8%) and nail abnormalities (3.4%) were the most common complications following composite grafting. Conclusion Composite grafting can be considered as a useful method of treatment in this population. Clinicians should be aware of the potential complications following this method of treatment such as infection and nail abnormalities. More proximal fingertip amputations may warrant other surgical interventions (beyond Level II on the modified Ishikawa/Ishikawa classification). Significant heterogeneity was observed within the studies, mainly due to lack of standardization in assessment and reporting of outcomes.
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Affiliation(s)
- Noemi Jester
- Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
- Sheffield Medical School, Sheffield University, Sheffield, United Kingdom
| | - Seunghee Han
- Birmingham Medical School, Birmingham University, Birmingham, United Kingdom
| | - Manwi Singh
- Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
- Sheffield Medical School, Sheffield University, Sheffield, United Kingdom
| | - Avula Aishwarya Rao
- Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
- Sheffield Medical School, Sheffield University, Sheffield, United Kingdom
| | - Balamrit Sokhal
- Keele Medical School, Keele University, Newcastle-under-Lyme United Kingdom
| | - Yangmyung Ma
- Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
| | - Andrea Jester
- Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
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Yi HS, Kim BS, Kim YS, Park JH, Kim HI. What Is the Minimum Number of Sutures for Microvascular Anastomosis during Replantation? J Clin Med 2023; 12:jcm12082891. [PMID: 37109227 PMCID: PMC10143759 DOI: 10.3390/jcm12082891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/09/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
As vessel diameter decreases, reperfusion after anastomosis becomes more difficult. When a blood vessel is sutured, its inner diameter becomes narrower owing to the thickness of the suture material and the number of sutures. To minimize this, we attempted replantation using a 2-point suture technique. We reviewed cases of arterial anastomosis in vessels with a diameter of less than 0.3 mm during replantation performed over a four-year period. In all cases, close observation was followed by absolute bed rest. If reperfusion was not achieved, a tie-over dressing was applied, and hyperbaric oxygen therapy was administered in the form of a composite graft. Of the 21 replantation cases, 19 were considered successful. Furthermore, the 2-point suture technique was performed in 12 cases, of which 11 survived. When three or four sutures were performed in nine patients, eight of these cases survived. Composite graft conversion was found in three cases in which the 2-point suture technique was used, and two of these cases survived. The survival rate was high in cases where 2-point sutures were used, and there were few cases of conversion to a composite graft. Reducing the number of sutures aids in optimizing reperfusion.
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Affiliation(s)
- Hyung-Suk Yi
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea
| | - Byeong-Seok Kim
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea
| | - Yoon-Soo Kim
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea
| | - Jin-Hyung Park
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea
| | - Hong-Il Kim
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Republic of Korea
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Abstract
Following a fingertip amputation, if vessels are present and of adequate condition, microsurgical replantation is the preferred technique for management. Composite grafting has a limited role in the management of fingertip amputations due to its unreliable nature but can be an option when an amputated fingertip is not replantable and the patient desires restoration of fingertip length and aesthetics. When composite grafting is selected as the treatment of choice for a particular patient, there are methods of optimizing the chances of graft revascularization and survival, including early grafting, graft cooling, and a moist wound healing environment.
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Affiliation(s)
- Kate Elzinga
- Section of Plastic Surgery, University of Calgary, South Health Campus, 4448 Front Street Southeast, Calgary, Alberta T3M 1M4, Canada.
| | - Kevin C Chung
- Section of Plastic Surgery, The University of Michigan Medical School, The University of Michigan Health System, 1500 East Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, MI 48109-0340, USA
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Composite grafts for fingertip amputations: A systematic review protocol. Int J Surg Protoc 2019; 16:1-4. [PMID: 31897441 PMCID: PMC6921220 DOI: 10.1016/j.isjp.2019.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/05/2019] [Accepted: 05/21/2019] [Indexed: 11/20/2022] Open
Abstract
Background There is much debate in the hand surgery literature as to the management of fingertip amputations. Much research continues to be published in this area. Methods of reattachment include microsurgical and non-microsurgical (composite graft) replantation. The role of composite grafts lacks clarity in terms of outcomes, success rates and complications. Hence there is a need for an evidence synthesis, which can guide patient selection, the consent process and determine graft survival rates and functional outcomes to optimise patient outcomes. Methods Search of the databases OVID MEDLINE, PubMed, EMBASE, SCOPUS, The Cochrane Library and clinical trial registries from inception using terms "fingertip" "digital tip" "digit" "finger" "thumb" "amputation" "replantation" "reattachment" "reimplantation" and "composite graft" as key terms with "AND" selected as a Boolean operator, limited to humans will be conducted by two independent researchers. The patient population will include adults and children. Studies will be included if they report: (1) primary data; (2) outcomes of 'composite grafts' or 'nonmicrosurgical replantations'; (3) graft survival, (4) 5 or more cases. Articles will be excluded if surgical techniques involve: (1) composite graft pocketing, or (2) microsurgical replantation or (3) additional flaps (pulp or local). Full exclusion and inclusion criteria are described within this protocol. Data extraction will include; demographic details, patient comorbidities, amputation nature and level, functional, and aesthetic outcomes, complications and need for secondary procedures. All data extracted will be cross-checked, and discrepancies resolved through consensus. Dissemination This review will be published in a peer-reviewed journal and will be presented at national and international conferences to inform the practice of other clinicians.
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Eo S, Doh G, Lim S, Hong KY. Analysis of the risk factors that determine composite graft survival for fingertip amputation. J Hand Surg Eur Vol 2018; 43:1030-1035. [PMID: 30176751 DOI: 10.1177/1753193418795820] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The composite graft is the only surgical method that is able to maintain digital length and provide soft tissue coverage without donor site morbidities in microsurgically non-replantable fingertip amputations. This study aimed to explore the risk factors that determine the survival of composite grafts. Clinical characteristics associated with graft survival were retrospectively analysed by a comparison between the graft survival and failure groups. Of 94 patients who underwent a composite graft for fingertip amputation, the graft survived in 84 (89%). Surviving grafts showed reperfusion within 1 week. Multivariate analysis revealed that graft failure was independently associated with a crushing injury. Based on the risk factors from the comparison analyses and a review of previously published studies, a cutting injury, grafting the injured finger within 5 hours of injury, and being a non-smoker are associated with good results. In these circumstances, excellent outcomes with a high success rate can be achieved by composite graft in most adult patients as an alternative treatment to microsurgical replantation. Level of evidence: IV.
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Affiliation(s)
- SuRak Eo
- Department of Plastic and Reconstructive Surgery, Dongguk University Ilsan Hospital, Goyang, Korea
| | - GyeongHyeon Doh
- Department of Plastic and Reconstructive Surgery, Dongguk University Ilsan Hospital, Goyang, Korea
| | - SooA Lim
- Department of Plastic and Reconstructive Surgery, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Ki Yong Hong
- Department of Plastic and Reconstructive Surgery, Dongguk University Ilsan Hospital, Goyang, Korea
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Composite Grafts for Pediatric Fingertip Amputations: A Retrospective Case Series of 100 Patients. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2018; 6:e1843. [PMID: 30276062 PMCID: PMC6157946 DOI: 10.1097/gox.0000000000001843] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/04/2018] [Indexed: 12/16/2022]
Abstract
Supplemental Digital Content is available in the text. Background: Fingertip amputations are common. This study reports on the outcomes of composite grafts used for fingertip amputations in children, measuring graft take, predictors of graft take, complications, and patient-reported outcomes. Methods: A retrospective case series of consecutive patients (≤ 16 years) undergoing composite grafts for fingertip amputations in a tertiary pediatric hospital, January 06 to December 16, was performed. Information was collected on amputations, graft take, and complications. Logistic regression was used to analyze factors predicting graft take (partial/complete or failure) including age; amputation level; mechanism and time delay to surgery. Patients were contacted via post or telephone to ask about functional and cosmetic outcomes and their perception of graft take. Results: One hundred patients [57 (57%) males; mean age, 4.41 ± 3.98 years], presenting with 100 fingertip amputations, met the inclusion criteria. Amputation mechanism was crush in 75 (75%), avulsion in 13 (13%), and laceration in 12 (13%). Thirteen (13%) composite grafts survived completely, 46 (46%) partially, and 41 (41%) failed. Graft survival was higher in children under 4 years (P = 0.016). Seventeen (17%) grafts became infected, 9 (9%) required a reoperation, 9 (9%) had wound healing complications, and 4 (4%) patients developed psychological complications. Patient-reported survival was 33% higher than medical-reported survival. Cosmetic issues were the commonest complication reported by patients. Patients rated fingertips looking 3.5/5 normal, and that they were 4/5 satisfied with the appearance. Most patients were using their fingers normally by 2–6 months. Conclusions: Composite grafts for fingertip amputations mostly only partially survive, but morbidity is low, patient satisfaction is high, and acceptable cosmetic and functional outcomes are achieved.
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Abstract
The management strategy proposed herein for fingertip amputations advocates secondary healing with preservation of appearance as well as function. Conservative healing is more likely to result in a sensate, nontender, and cosmetically acceptable fingertip compared to surgical management in many clinical scenarios. This manuscript examines in detail the extent of fingertip injury and defines the relationship of injury to final fingertip outcome. A classification is presented, which allows adequate initial counseling regarding prognosis, and predicts the need for secondary corrective surgery.
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Lai HT, Wu SH, Lai YW, Hsieh TY, Lee SS, David Wang HM, Chang KP, Lin SD, Lai CS, Huang SH. Composite grafting with pulp adipofascial advancement flaps for treating non-replantable fingertip amputations. Microsurgery 2016; 36:651-657. [DOI: 10.1002/micr.30051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 01/24/2016] [Accepted: 03/17/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Hsin-Ti Lai
- Division of Plastic Surgery, Department of Surgery; Kaohsiung Medical University Hospital, Kaohsiung Medical University; Kaohsiung Taiwan
| | - Sheng-Hua Wu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Anesthesia; Kaohsiung Medical University Hospital, Kaohsiung Medical University; Kaohsiung Taiwan
| | - Ya-Wei Lai
- Division of Plastic Surgery, Department of Surgery; Kaohsiung Medical University Hospital, Kaohsiung Medical University; Kaohsiung Taiwan
| | - Tung-Ying Hsieh
- Division of Plastic Surgery, Department of Surgery; Kaohsiung Medical University Hospital, Kaohsiung Medical University; Kaohsiung Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery; Kaohsiung Medical University Hospital, Kaohsiung Medical University; Kaohsiung Taiwan
- Center for Stem Cell Research, Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Hui-Min David Wang
- Center for Stem Cell Research, Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Fragrance and Cosmetic Science; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Kao-Ping Chang
- Division of Plastic Surgery, Department of Surgery; Kaohsiung Medical University Hospital, Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Sin-Daw Lin
- Division of Plastic Surgery, Department of Surgery; Kaohsiung Medical University Hospital, Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Chung-Sheng Lai
- Division of Plastic Surgery, Department of Surgery; Kaohsiung Medical University Hospital, Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Shu-Hung Huang
- Division of Plastic Surgery, Department of Surgery; Kaohsiung Medical University Hospital, Kaohsiung Medical University; Kaohsiung Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University; Kaohsiung Taiwan
- Center for Stem Cell Research, Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
- Orthopaedic Research Center, Kaohsiung Medical University; Kaohsiung Taiwan
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Rinkevich Y, Maan ZN, Walmsley GG, Sen SK. Injuries to appendage extremities and digit tips: A clinical and cellular update. Dev Dyn 2016; 244:641-50. [PMID: 25715837 DOI: 10.1002/dvdy.24265] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 01/12/2015] [Accepted: 02/16/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The regrowth of amputated appendage extremities and the distal tips of digits represent models of tissue regeneration in multiple vertebrate taxa. In humans, digit tip injuries, including traumatic amputation and crush injuries, are among the most common type of injury to the human hand. Despite clinical reports demonstrating natural regeneration of appendages in lower vertebrates and human digits, current treatment options are suboptimal, and are complicated by the anatomical complexities and functions of the different tissues within the digits. RESULTS In light of these challenges, we focus on recent advancements in understanding appendage regeneration from model organisms. We pay special attention to the cellular programs underlying appendage regeneration, where cumulative data from salamanders, fish, frogs, and mice indicate that regeneration occurs by the actions of lineage-restricted precursors. We focus on pathologic states and the interdependency that exists, in both humans and animal models, between the nail organ and the peripheral nerves for successful regeneration. CONCLUSIONS The increased understanding of regeneration in animal models may open new opportunities for basic and translational research aimed at understanding the mechanisms that support limb regeneration, as well as amelioration of limb abnormalities and pathologies.
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Affiliation(s)
- Yuval Rinkevich
- Institute for Stem Cell Biology and Regenerative Medicine, Departments of Pathology and Developmental Biology, Stanford University School of Medicine, Stanford, California
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Han D, Sun H, Jin Y, Wei J, Li Q. A technique for the non-microsurgical reconstruction of thumb tip amputations. J Plast Reconstr Aesthet Surg 2013; 66:973-7. [DOI: 10.1016/j.bjps.2013.03.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 02/14/2013] [Accepted: 03/09/2013] [Indexed: 11/16/2022]
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Innervated digital artery perforator flap. J Hand Surg Am 2013; 38:350-6. [PMID: 23218789 DOI: 10.1016/j.jhsa.2012.10.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2012] [Revised: 10/05/2012] [Accepted: 10/11/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE To describe a technique for covering defects of the fingertips: the innervated digital artery perforator (IDAP) flap. METHODS A total of 17 patients were treated with an IDAP flap. The size of the flaps varied between 2 ×1 cm and 3.5 × 2 cm. Postoperative evaluation of the patients consisted of the Semmes-Weinstein Monofilament test, static 2-point discrimination, patient satisfaction, extension loss, and an investigation into complications. RESULTS All IDAP flaps survived completely, and no patients required secondary interventions. The mean follow-up period was 7 months (range, 6-10 mo). The Semmes-Weinstein monofilament test results ranged from 3.22 to 3.84. The static 2-point discrimination in the flaps ranged from 2 mm to 4 mm (mean, 3.4 mm) compared with a range of 2 mm to 3 mm (mean, 2.7 mm) on the contralateral hand. There were no joint contractures in the reconstructed fingertips, although 2 patients developed mild hook nail deformity. One patient experienced mild cold intolerance, and 1 patient exhibited mild postoperative hypersensitivity. CONCLUSIONS The advantages of the IDAP flap include minimally invasive surgery; a reliable, versatile flap; and the ease of the technique for different-sized fingertip defect reconstructions with few complications. The IDAP flap may be useful in fingertip amputations when the amputated part is not suitable for replantation. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.
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Treatment and Outcomes of Fingertip Injuries at a Large Metropolitan Public Hospital. Plast Reconstr Surg 2013; 131:107-112. [DOI: 10.1097/prs.0b013e3182729ec2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Treatment of fingertip amputation in adults by palmar pocketing of the amputated part. Arch Plast Surg 2012; 39:404-10. [PMID: 22872846 PMCID: PMC3408288 DOI: 10.5999/aps.2012.39.4.404] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 05/06/2012] [Accepted: 05/07/2012] [Indexed: 12/04/2022] Open
Abstract
Background First suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults. Methods Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm. Results Of a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results. Conclusions A composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.
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Abstract
BACKGROUND Fingertip amputation is the most common type of injury in the upper limb. Goals in fingertip amputation reconstruction are covering the defect, establishing maximum tactile gnosis, keeping the length of the finger, protecting the joint function, acquiring a well-padded pulp tissue, providing a bed for growing nail, obtaining a satisfactory cosmetic appearance and allowing the patient to return to work as soon as possible. Adjacent skin and soft tissue are the best covers for fingertip injuries. However, local homodigital flaps lack enough tissue to cover the defect. To solve this problem, we used V-Y rotation advancement flap bilaterally in fingertip amputations which meets all the reconstruction goals. Rotation besides advancement makes this flap more mobile and easier to cover larger defects in all amputation planes. METHODS Between 2007 and 2009, we performed bilateral V-Y rotation advancement flap on seven male patients' pulpa (average age, 37.6 years) whose fingertips were not replantable. RESULTS Fourteen flaps were made on 7 fingers. There was neither total nor partial flap loss. Patients had neither cold intolerance nor scar hypersensitivity. Stiffness of the PIP joint did not occur. No obvious hooked nail occurred in patients who have remaining nail matrix. Because flaps contain neurovascular bundle, there was no difference in sensation and perfusion between the finger's pre-operative and post-operative status. The result was satisfactory with painless pinching. CONCLUSION In addition to the various and versatile fingertip reconstruction methods, we want to present V-Y rotation advancement flap as a quick, reliable and aesthetic method.
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Abstract
Abstract Fifteen patients (aged 21-45 years) with avulsion injuries to a fingertip were reviewed. We report a new technique, in which the subcutaneous pulp flap is combined with the cap technique of the nail complex, for avulsed fingertips in adults. The bone of the avulsed part is excised and the fat removed. The nail complex is preserved, and the subcutaneous pulp flap used to improve the take at the cap-nail complex. This technique is simple, safe, and cost and time effective. It is a good option for repair of an avulsed fingertip.
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Affiliation(s)
- Dong Han
- Department of Plastic and Reconstructive Surgery, Ninth People's Hospital, Medical School of Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Composite Grafting for Traumatic Fingertip Amputation in Adults: Technique Reinforcement and Experience in 31 Digits. ACTA ACUST UNITED AC 2011; 70:148-53. [DOI: 10.1097/ta.0b013e3181cc8553] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Urso-Baiarda FG, Wallace CG, Baker R. Post-traumatic composite graft fingertip replantation in both adults and children. EUROPEAN JOURNAL OF PLASTIC SURGERY 2009. [DOI: 10.1007/s00238-009-0346-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Eo S, Hur G, Cho S, Azari KK. Successful composite graft for fingertip amputations using ice-cooling and lipo-prostaglandin E1. J Plast Reconstr Aesthet Surg 2009; 62:764-70. [DOI: 10.1016/j.bjps.2007.09.064] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Accepted: 09/05/2007] [Indexed: 10/22/2022]
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