Avulsion injuries of the nail bed do not need nail bed graft.

From 1985 to 1992, 12 cases of severe avulsion injuries of the nail bed were treated by allowing the nail bed to regenerate naturally, without a nail bed graft irrespective of the extent of nail bed loss. This involved simply covering the residual nail bed with the nail splint for a period of approximately 6 weeks or until the nail bed was observed to be fully regenerated. The patients were then followed up until full nail growth. It was observed that the nail bed regenerated spontaneously, followed by a normal nail growth identical to the contralateral uninjured nail.Proper coverage of the nail bed protected the culture milieu conducive to natural nail bed regeneration, and nail bed grafting was not necessary irrespective of the extent of tissue loss.