Saha Srinjoy
Apollo Multispecialty Hospital, Kolkata, India.
J Stem Cells Regen Med. 2023 Apr 30;19(1):14-18. doi: 10.46582/jsrm.1901003. eCollection 2023.
The goals of treatment for fingertip injuries are maximising digital length, tactile sensation, pulp padding, and fingertip appearance while minimising complications like infection and amputation. Currently, terminalisation, healing by secondary intention, and flap surgeries are widely used for crushing fingertip injuries, but they have their own set of issues and limitations. We present a tissue-engineered method by combining platelet-rich fibrin injections with stacked-up layers of synthetic biodegradable temporising matrix to treat a severely crushed fingertip. This novel therapy minimised reconstructions while successfully regenerating new soft-tissues. Soft-tissue regeneration within the stacked-up biodegradable matrix achieved adequate volume, sensation, function, and mobility of the newly reconstructed fingertip while maintaining its skeletal length. Notably, the regenerated fingertip allowed the patient to resume work normally as a busy software engineer. Thus, minimalistic fingertip reconstruction not only prevented a disability, but also served as a viable alternative to major reconstructive surgeries.
指尖损伤的治疗目标是在最大限度减少感染和截肢等并发症的同时,最大化手指长度、触觉、指腹填充和指尖外观。目前,截指术、二期愈合和皮瓣手术广泛用于挤压性指尖损伤,但它们都有各自的问题和局限性。我们提出了一种组织工程方法,即将富含血小板的纤维蛋白注射与合成可生物降解临时基质的堆叠层相结合,以治疗严重挤压的指尖。这种新疗法在成功再生新软组织的同时,将重建手术减到最少。堆叠的可生物降解基质内的软组织再生实现了新重建指尖足够的体积、感觉、功能和活动度,同时保持了其骨骼长度。值得注意的是,再生的指尖使患者能够作为一名忙碌的软件工程师正常恢复工作。因此,简约的指尖重建不仅预防了残疾,而且是大型重建手术的可行替代方案。