Department of Plastic and Reconstructive Surgery, El-Sahel Teaching Hospital, Cairo, Egypt.
Department of Plastic and Reconstructive Surgery, Faculty of Medicine For Girls, Al-Azhar University, Nasr City, Cairo, Egypt.
J Orthop Surg Res. 2024 Nov 18;19(1):765. doi: 10.1186/s13018-024-05230-9.
Fingertip amputation is a commonly encountered injury in emergency settings. Composite grafting is a non-microsurgical alternative maintaining digit length with no donor site morbidities. This meta-analysis was conducted to retrieve factors associated with composite graft survivability among patients with fingertip amputations.
A literature review throughout twelve databases was performed on 24 July 2023. All clinical studies comparing the patients-related, trauma-related, or amputation-related variables among patients with survived and non-survived composite grafting were eligible for meta-analysis. Single-arm studies reported the potential predictors of composite graft survival among patients with fingertip injuries treated with composite grafting were included.
This review included ten articles with 720 fingertips composite grafting. Of them, 526 grafts survived, with a pooled overall survivability of 72.8%. There was a significant association between younger age (OR 2.31,95%CI 1.10, 4.87, P = 0.03), level of amputation (I) (OR 0.31,95% CI 0.14 to 0.67, P = 0.003), and successful composite grafting. There was no statistically significant (P = 0.449) impact of time to composite grafting on the likelihood of composite graft survivability.
Composite grafting is a feasible and effective procedure for restoring aesthetically functional digits among patients with traumatically amputated fingertips. The composite graft survived among the majority of the patients, with a more significant survival pattern among younger populations and patients with more distal amputations.
Level III.
指尖离断伤在急诊中较为常见。复合组织移植是一种非显微外科的替代方法，可以维持手指长度，且不存在供区并发症。本荟萃分析旨在检索与指尖离断伤患者的复合组织移植成活率相关的因素。
于 2023 年 7 月 24 日对 12 个数据库进行了文献回顾。所有比较患者相关、创伤相关或离断相关变量的临床研究，均符合纳入标准。对采用复合组织移植治疗指尖损伤的患者，单臂研究报告了复合组织存活的潜在预测因素，也纳入了本次分析。
本综述纳入了 10 项研究，共 720 例指尖复合组织移植。其中，526 例移植存活，总体成活率为 72.8%。年龄较小（OR 2.31，95%CI 1.104.87，P=0.03）、断指平面为 I 型（OR 0.31，95%CI 0.140.67，P=0.003）与成功的复合组织移植有显著相关性。复合组织移植时间对复合组织移植成活率无统计学意义（P=0.449）。
复合组织移植是修复创伤性指尖离断伤患者美观和功能的可行且有效的方法。大多数患者的复合组织移植存活，且年轻患者和断指平面更靠近指尖的患者，其存活的概率更高。
III 级。
