Fingertip Injuries Treated with Semi-occlusive Dressings
Abstract
Objective: To demonstrate that semi-occlusive dressings achieve reconstruction of the distal phalanx with no residual pain, no additional shortening, and a satisfactory aesthetic appearance. Materials and Methods: 47 fingers with distal injuries were assessed and classified into three groups: a) with skin and subcutaneous cellular tissue involvement, b) with an additional nail injury,and c) with an additional open bone injury. All were covered with a semi-occlusive bandage which was replaced weekly until the wound healed, which took around four weeks. Results: 41 of the 47 treated fingers displayed excellent functional and aesthetic outcomes, with complete recovery of distal sensibility; nevertheless, 6 patients (14%) required additional surgery, all of whom had work conflicts. The average time for complete healing was 45.7 days, with three dressing replacements required to complete treatment. Conclusion: Fingertip injuries, even with the phalanx exposed, can be satisfactorily treated with semi-occlusive dressings. Reconstruction is achieved without residual pain, without additional shortening, with good strength and sensitivity, and with an excellent aesthetic appearance of the phalanx. It is also an economical and simple to replicate method.Downloads
References
Bot AJG, Bossen JKJ, Mudgal CS, Jupiter JB, David Ring D. Determinants of disability after fingertip injuries. Psychosomatics 2014;55(4):372-80. https://doi.org/10.1016/j.psym.2013.08.005
Chang BL, Katz RD. Locoregional options for acute volar pulp fingertip defects. Hand Clin 2012;37(1):11-26. https://doi.org/10.1016/j.hcl.2020.09.004
van den Berg WB, Vergeer RA, van der Sluis CK, Ten Duis HJ, Werker PMN. Comparison of three types of treatment modalities on the outcome of fingertip injuries. J Trauma Acute Care Surg 2012;72(6):1681-7. https://doi.org/10.1097/TA.0b013e318248bc8c
de Boer P, Collinson PO. The use of silver sulphadiazine occlusive dressings for finger-tip injuries. J Bone Joint Surg Br 1981;63B(4):545-7. https://doi.org/10.1302/0301-620X.63B4.7298681
Mennen U, Wiese A. Fingertip injuries management with semi-occlusive dressing. J Hand Surg Br 1993;18(4):416-22. https://doi.org/10.1016/0266-7681(93)90139-7
Mühldorfer-Fodor M, Hohendorff B, Vorderwinkler K, van Schoonhoven J, Prommersberger K-J. Behandlung von Fingerkuppendefektverletzungen mit dem Semiokklusionsverband nach Mennen und Wiese. Oper Orthop Traumatol 2013;25(1):104-14. https://doi.org/10.1007/s00064-012-0192-5
Quadlbauer S, Pezzei Ch, Jurkowitsch J, Beer T, Keuchel T, Hausner T, et al. Der Okklusionsverband zur Behandlung von Allen III und IV Fingerkuppenverletzungen als Alternative zu lokalen Lappenplastiken. Unfallchirurg 2017;120(11):961-8. https://doi.og/10.1007/s00113-016-0237-6
Allen MJ. Conservative management of fingertip injuries in adults. Hand 1980;12(3):257-65.
https://doi.org/10.1016/s0072-968x(80)80049-0
Cosentino R, Cosentino RV. Miembro superior. Semiología con consideraciones clínicas y terapéuticas. Serie Ciencia del Puño y Letra. Buenos Aires: Graficar; 2001, p. 272-3.
Ha NB, Chang AC, Sullivan JS, Leonello DT. Non-operative management of fingertip injuries with an intravenous dressing. J Wound Care 2015;24(6):276-9. https://doi.org/10.12968/jowc.2015.24.6.276
Ordosch M, Maucher V. The semi-occlusive dressing – development of the confidence of the patients in the treatment and the odour emission during the treatment period. Handchir Mikrochir Plast Chir 2020;52(3):189-91. https://doi.org/10.1055/a-1164-6645
Schultz J, Leupold S, Grählert X, Pfeiffer R, Schwanebeck U, Schröttner P, et al. Study protocol for a randomized controlled pilot trial on the semiocclusive treatment of fingertip amputation injuries using a novel finger cap. Medicine (Baltimore) 2017;96(41):e8224. https://doi.org/10.1097/MD.0000000000008224
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
