Outcomes of Composite Grafts for Pediatric Fingertip Amputations: A Systematic Review

Jester, Noemi; Han, Seunghee; Singh, Mandeep; Rao, A.; Sokhal, Balamrit Singh; Ma, Yangmyung; Jester, Andrea

doi:10.1055/s-0043-1771295

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…Traditionally, syndactyly and burn injuries are repaired with skin grafts. However, recent advancements in synthetic dermal substitutes such as Integra Dermal Regenerative Template (Integra, Plainsboro, NJ), Hyalomatrix Hyaluronic Acid Wound Device (Anika, Bedford, MA), and MatriDerm (MedSkin, Billerbeck, Germany) have shown similar outcomes [5][6][7]. Given this, dermal substitutes have become an increasingly popular option for children with complex soft-tissue defects.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of a Pediatric Distal Phalanx Amputation With Stacked Integra Dermal Substitute: A Case Report

Kelley,

Shaver,

Morrell

2024

Cureus

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Finger amputations in children present unique challenges and require special considerations compared to their adult counterparts. Maximizing length and preserving fingertip bulk and sensation is essential for maintaining a functional digit. Synthetic dermal substitutes have been recently used for soft tissue coverage for pediatric syndactyly as well as burn injuries; however, the literature discussing pediatric amputation cases with soft tissue damage proximal to the bony level is limited. In this case, we report a two-year-old patient who developed dry gangrene of her right index finger after multiple rabbit bites and underwent an amputation through the distal interphalangeal joint. Circumferential soft-tissue debridement proximal to the tip of the middle phalanx was required, leaving substantial exposed bone with no soft tissue envelope. We report our experience of single-stage stacking Integra dermal substitute directly onto the exposed bone to provide both finger bulk and soft tissue coverage. The patient displayed no functional limitations three years post-surgery. For instances when local or distant flap coverage may not be feasible, we present a novel technique to reconstruct, provide bulk, and preserve length in pediatric finger amputations. This case highlights that the utility of dermal substitutes is expanding and are providing more technical options.

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Section: Introductionmentioning

confidence: 99%

Reconstruction of a Pediatric Distal Phalanx Amputation With Stacked Integra Dermal Substitute: A Case Report

Kelley,

Shaver,

Morrell

2024

Cureus

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Salvage composite graft for an Allen’s IV right ring finger avulsion injury and delayed presentation in a 15-year-old boy

Wong,

bin Zainuddin,

Mahadev

2024

Journal of Orthopaedic Reports

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The reconstruction of fingertip injury with partial defect of nailbed and skin by hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein transplantation：a retropective study

Zheng,

Wang,

Zhou

et al. 2024

Preprint

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Introduction:How to reconstruct fingertip injury with partial defect of nailbed and skin is a clinical problem. Our team design the hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein to reconstruct fingertip injury with partial defect of nailbed and skin for a long time. Thus, we perform the retrospective study to evaluate the effects of this technique on fingertip injury with partial defect of nailbed and skin. Materials and methods:A retrospective analysis was performed on 40 patients with fingertip injury with partial defect of nailbed and skin admitted to our hospital from January 2016 to January 2020 who were treated by the hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein. During the follow-up, we recorded the operation time, intraoperative blood loss, the size of the transplanted flap, complications, the survival rate of the transplanted flap, total nail growth time, Semmes-Weinstein evaluating tactile sensation, two-point discrimination testing (TPD) and observed the appearance of reconstructed fingertip. Results:The operation time was (3.62±0.47) hours, the intraoperative blood loss was (31.77±4.54) ml, the size of transplanted flap was 12 mm × 7 mm to 19 mm × 10 mm, the survival rate of the transplanted flap was 100%. During the (26.82±4.47) months follow-up, the total nail growth time was (9.14±1.78) months and there is no complications. The average tactile sensation evaluated by the Semmes-Weinstein test and the average TPD of reconstructed fingertip was (0.31±0.15) g and (7.26±1.26) mm separately. The reconstructed fingertips had beautiful appearance and walking function of foots providing flaps was not influenced. Conclusions:The hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein transplantation is an effective method to reconstruct fingertip injury with partial defect of nailbed and skin with a beautiful appearance and excellent function. Type of study/level of evidence Therapeutic IV.

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Outcomes of Composite Grafts for Pediatric Fingertip Amputations: A Systematic Review

Cited by 3 publications

References 26 publications

Reconstruction of a Pediatric Distal Phalanx Amputation With Stacked Integra Dermal Substitute: A Case Report

Reconstruction of a Pediatric Distal Phalanx Amputation With Stacked Integra Dermal Substitute: A Case Report

Salvage composite graft for an Allen’s IV right ring finger avulsion injury and delayed presentation in a 15-year-old boy

The reconstruction of fingertip injury with partial defect of nailbed and skin by hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein transplantation：a retropective study

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