Kang Daihun
Department of Plastic and Reconstructive Surgery, Ewha Womans University Seoul Hospital, Seoul 03760, Republic of Korea.
J Clin Med. 2024 Jun 21;13(13):3646. doi: 10.3390/jcm13133646.
Fingertip injuries with volar pulp tissue defects present a significant challenge in management. This study aimed to evaluate the efficacy of a conservative treatment protocol using artificial dermis and semi-occlusive dressings for these injuries. A single-center, prospective study was conducted on 31 patients with fingertip injuries involving volar pulp defects. The treatment protocol included wound debridement, application of artificial dermis (Pelnac), and a semi-occlusive dressing (IV3000). The outcomes were assessed using subjective questionnaires and objective measures, including fingerprint regeneration, sensory function, pain, and cosmetic appearance. The mean treatment duration was 45.29 days (SD = 17.53). Complications were minimal, with only one case (3.22%) directly attributable to the treatment. Fingerprint regeneration was considerable (mean score = 2.58, SD = 0.67). The sensory disturbances were minimal, with no significant differences across injury types. Post-treatment pain was low (mean = 0.45, SD = 0.67), and cosmetic satisfaction was high (mean = 4.09, SD = 0.94). The overall patient satisfaction was high (mean = 4.41, SD = 0.67), regardless of injury severity. The conservative treatment protocol using artificial dermis and semi-occlusive dressings is a promising strategy for managing fingertip injuries with volar pulp defects. This approach minimizes surgical morbidity and achieves excellent functional and aesthetic outcomes.
伴有掌侧指腹组织缺损的指尖损伤在治疗上极具挑战性。本研究旨在评估使用人工真皮和半封闭敷料的保守治疗方案对这些损伤的疗效。对31例伴有掌侧指腹缺损的指尖损伤患者进行了一项单中心前瞻性研究。治疗方案包括伤口清创、应用人工真皮(Pelnac)和半封闭敷料(IV3000)。通过主观问卷和客观指标评估结果,包括指纹再生、感觉功能、疼痛和外观。平均治疗时间为45.29天(标准差=17.53)。并发症极少,仅有1例(3.22%)直接归因于治疗。指纹再生情况良好(平均评分=2.58,标准差=0.67)。感觉障碍轻微,不同损伤类型之间无显著差异。治疗后疼痛程度较低(平均=0.45,标准差=0.67),外观满意度较高(平均=4.09,标准差=0.94)。无论损伤严重程度如何,患者总体满意度较高(平均=4.41,标准差=0.67)。使用人工真皮和半封闭敷料的保守治疗方案是治疗伴有掌侧指腹缺损的指尖损伤的一种有前景的策略。这种方法可将手术发病率降至最低,并取得优异的功能和美学效果。