Successful composite graft for fingertip amputations using ice-cooling and lipo-prostaglandin E1

Composite Grafting for Traumatic Fingertip Amputation in Adults: Technique Reinforcement and Experience in 31 Digits

“…Table 2 provides a comparison between our results and those reported in the literature. [3][4][5]31,32 The success rate of our series was satisfactory, and the objective 2-point discrimination was acceptable. The esthetic result evaluated by the patients' self-report indicated that nearly all patients (93.5%) were satisfied and two patients had complications.…”

“…Application of pharmacologic agents after composite grafting surgery increases graft survival. 5,22,23 Several studies have reported that hyperbaric oxygen therapy is useful for larger composite grafts, although these are limited to animal models, and this method has not been shown to be effective in clinical research. 24,25 Rose et al 26 first described the "cap" technique for enhancing composite graft survival by increasing the contact area between the distal amputated fingertip and the amputated stump.…”

“…Although composite grafting has a high success rate and produces good results in treating fingertip amputations in children, it has a lower success rate in adults. [3][4][5] Here, we demonstrate the technical reinforcement of a composite graft to achieve a higher success rate for the graft take in adults.…”

Composite grafting with pulp adipofascial advancement flaps for treating non‐replantable fingertip amputations

“…Hirase reported that postoperative cooling of the entire recipient site enhances composite graft survival by retarding cellular degeneration in the graft until neovascularization . Other pharmacological agents, such as lipoprostaglandin E1, were used after composite grafting to improve the survival rate . Some studies have reported that hyperbaric oxygen therapy improved the survival of large auricular composite grafts in animal models .…”

Hand Injuries in Children

“…The technique requires defatting of the graft and precise dermal apposition to optimize the revascularization of the graft. The survival of the graft can be improved by cooling, Prostaglandin E1 [ 15 ] or hyperbaric treatment.…”