Pastor, Tatjana; Hermann, Patricia; Haug, Luzian; Gueorguiev, Boyko; Pastor, Torsten; Vögelin, Esther (2023). Semi-occlusive dressing therapy versus surgical treatment in fingertip amputation injuries: a clinical study. European journal of trauma and emergency surgery, 49(3), pp. 1441-1447. Springer-Medizin-Verlag 10.1007/s00068-022-02193-6
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OBJECTIVES
Treatment of fingertip amputations is subject of controversial debates. Recently, semi-occlusive dressings have increased in popularity in these injuries.
AIMS
To compare clinical outcomes of conservative semi-occlusive dressing therapy versus surgical treatment of fingertip amputations.
METHODS
Eighty-four patients with fingertip amputations were re-examined clinically after a mean follow-up of 28.1 months (range 9.6-46.2). Sixty-six patients (79%) were treated with semi-occlusive dressings (group 1) and 18 (21%) underwent surgery (group 2). Range of motion, grip strength, and two-point discrimination were measured at the final follow-up. Furthermore, VAS score, Quick-DASH score, subjective aesthetic outcome and loss of working days were obtained.
RESULTS
Group 1 demonstrated healing in all 66 patients (100%) while in Group 2 5 out of 18 patients (28%) failed to achieve healing after a mean of 17 days (range 2-38) due to graft necrosis. Group 1 showed significantly lower VAS scores and significantly lower loss of two-point discrimination compared to Group 2. Work absence was significantly shorter in Group 1 versus Group 2. Trophic changes in finger (46%) and nail (30%) were significantly lower in Group 1 compared to Group 2 (44% and 70%, respectively). Disturbance during daily business activities (14%) and cold sensitivity (23%) were significantly lower in Group 1 compared to Group 2 (86% and 77%, respectively).
CONCLUSIONS
Semi-occlusive dressing therapy for fingertip amputations demonstrated excellent healing rates. Compared to surgical treatment, it resulted in significantly better clinical outcomes, lower complication rates and significantly higher reported satisfaction rates. Therefore, semi-occlusive dressing for fingertip injuries is a very successful procedure and shall be preferred over surgical treatment in most cases.
LEVEL OF EVIDENCE
III therapeutic.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery 04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Hand Surgery |
UniBE Contributor: |
Pastor, Tatjana, Haug, Luzian Carlo Peter, Vögelin, Esther |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1863-9933 |
Publisher: |
Springer-Medizin-Verlag |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
12 Dec 2022 11:20 |
Last Modified: |
31 May 2023 00:12 |
Publisher DOI: |
10.1007/s00068-022-02193-6 |
PubMed ID: |
36495343 |
Uncontrolled Keywords: |
Finger replantation Fingertip amputation Hand surgery Microsurgery Semi-occlusive dressing |
BORIS DOI: |
10.48350/175722 |
URI: |
https://boris.unibe.ch/id/eprint/175722 |
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