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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 3/2023

Open Access 10-12-2022 | Fingertip Injury | Original Article

Semi-occlusive dressing therapy versus surgical treatment in fingertip amputation injuries: a clinical study

Authors: Tatjana Pastor, Patricia Hermann, Luzian Haug, Boyko Gueorguiev, Torsten Pastor, Esther Vögelin

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2023

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Abstract

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.
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Metadata
Title
Semi-occlusive dressing therapy versus surgical treatment in fingertip amputation injuries: a clinical study
Authors
Tatjana Pastor
Patricia Hermann
Luzian Haug
Boyko Gueorguiev
Torsten Pastor
Esther Vögelin
Publication date
10-12-2022
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 3/2023
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-022-02193-6

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