Post-traumatic composite graft fingertip replantation in both adults and children

Post-traumatic composite graft fingertip replantation in both adults and children Composite graft fingertip replacement (CGFR) can maintain digital length and a normal nail complex when microvascular replantation of traumatically amputated fingertips is unfeasible. However, there remains reluctance to perform CGFR in adults owing to perceived poor outcomes compared with children, despite a lack of supporting evidence. We report CGFR outcome in adults and children. A prospectively collated patient information database identified CGFR attempts over five consecutive years. Patient demographics and co-morbidities, injury mechanisms and details (including Ishikawa levels), timing of surgical interventions and outcomes were documented. One hundred thirty-one CGFRs were attempted in 130 patients (106 in children under 16). Ishikawa amputation level or CGFR outcome was not documented in 21 excluded cases. Despite a significant association between adulthood and smoking, complete or partial graft survival was excellent in both adults and children (86% and 89%, respectively). Adults and children were significantly more likely to sustain laceration and crush injuries, respectively. These results challenge the near-universal scepticism held against CGFR in adults. Partial graft survival can appear discouraging when mummified eschar conceals regenerating tissue beneath. We emphasise the importance of patience in the clinical management of fingertip injuries treated by CGFR with two representative cases where the graft was considered ‘completely necrotic’ but ultimately survived to generate normal nail growth with an excellent cosmetic and functional result. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Post-traumatic composite graft fingertip replantation in both adults and children

Loading next page...
 
/lp/springer_journal/post-traumatic-composite-graft-fingertip-replantation-in-both-adults-jgjK7VDt5J
Publisher
Springer-Verlag
Copyright
Copyright © 2009 by Springer-Verlag
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-009-0346-3
Publisher site
See Article on Publisher Site

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 12 million articles from more than
10,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Unlimited reading

Read as many articles as you need. Full articles with original layout, charts and figures. Read online, from anywhere.

Stay up to date

Keep up with your field with Personalized Recommendations and Follow Journals to get automatic updates.

Organize your research

It’s easy to organize your research with our built-in tools.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

Monthly Plan

  • Read unlimited articles
  • Personalized recommendations
  • No expiration
  • Print 20 pages per month
  • 20% off on PDF purchases
  • Organize your research
  • Get updates on your journals and topic searches

$49/month

Start Free Trial

14-day Free Trial

Best Deal — 39% off

Annual Plan

  • All the features of the Professional Plan, but for 39% off!
  • Billed annually
  • No expiration
  • For the normal price of 10 articles elsewhere, you get one full year of unlimited access to articles.

$588

$360/year

billed annually
Start Free Trial

14-day Free Trial