[Outcomes of fingertip injury treatment with semi-occlusive dressings combined with surgical management within an expanded indication].

Since their introduction by Mennen and Wiese in 1993, semi-occlusive film dressings (SOFD) have been increasingly used in various clinical contexts, including the treatment of Allen type IV fingertip injuries, fingertip necrosis, and cases involving embedded foreign material.This study aimed to investigate whether and, if so, how the outcomes of Allen type III and IV fingertip injuries and fingertip necrosis differ from those of Allen types I and II. In addition, it aimed to investigate if the presence of embedded foreign material under a film dressing increases the risk of complications.A total of 50 patients with 44 fingertip injuries and 13 fingertip necroses were treated with an SOFD in combination with surgical intervention. In 22 out of 50 patients, foreign material was present under the film dressings. During follow-up, cold sensitivity, pain at rest and during activity, the usage of the injured finger in daily life, patient satisfaction with the aesthetic outcome, sensitivity, sweat secretion, papillary ridges, nail deformity, and mobility were assessed. The fingertips were examined for nail growth abnormalities. The results of the Allen type I-IV fingertip injuries and fingertip necrosis were compared with each other and related to findings from the uninjured fingers of the opposite hand. Clinical outcomes showed that SOFD led to good fingertip regeneration at any amputation level and in cases of fingertip necrosis. However, nail deformities increased with shorter lengths of the distal phalanx. Patients with necrosis were less satisfied with the aesthetic outcome compared to those receiving primary treatment after amputation injury. The presence of foreign material under the film dressings did not influence the healing process, and no infections were observed.SOFDs demonstrate good outcomes in Allen type III and IV fingertip injuries as well as in fingertip necrosis, comparable to those of Allen type I and II. However, it is essential to inform patients about potential risks such as nail deformities and compromised aesthetic appearance. Surgical interventions involving foreign material under an SOFD do not affect the healing of fingertip injuries, thus allowing for an expanded range of indications for SOFDs.