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用于指尖截肢处理的半封闭敷料:一项系统评价

Semi-occlusive dressings for the management of fingertip amputations: A systematic review.

作者信息

Esmaeil Ali, Al-Naseem Abdulrahman O, Lari Ali, Prada Carlos

机构信息

Orthopedic Departments, Al-Razi Orthopedic Hospital, Ministry of Health, Sulaibkhat, Jamal Abdel Nasser Street PO Box 5, 13001, Kuwait City, Kuwait.

Department of Orthopedic Surgery, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, edificio académico escuela de medicina, Santiago, Chile, 8330077.

出版信息

J Hand Microsurg. 2025 Mar 1;17(3):100241. doi: 10.1016/j.jham.2025.100241. eCollection 2025 May.

Abstract

BACKGROUND

Fingertip amputations can be managed using a number of surgical and nonsurgical techniques including semi-occlusive dressings.

AIM

The aim of this systematic review is to assess the efficacy and safety of semi-occlusive dressings for fingertip amputations.

METHODS

A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The following databases were searched: Medline, Embase and CINAHL. The primary outcomes included healing rate and time to epithelialization. Secondary outcomes included patient satisfaction, finger range of motion (ROM), patient reported outcome measures (PROMs), fingertip sensitivity, need for surgical intervention and complications.

RESULTS

A total of 15 studies met the inclusion criteria with a total of 611 fingertip amputations. The mean overall healing rate was 97.4 % and the mean time to complete epithelialization was 30 days. Ninety three percent of patients achieved full ROM. A 96.5 % of patients reported being either satisfied or very satisfied with their outcome. Mean time to return to work was 22.3 days. Complications were reported in 31 % of patients, most of which were considered minor. Only 1.5 % of patients required surgical intervention.

CONCLUSION

Semi-occlusive dressing therapy is a safe and effective treatment modality for patients with fingertip amputations without bone exposure. Further comparative studies are needed to outline the role and protocols of semi-occlusive dressings in fingertip amputations.

摘要

背景

指尖截肢可以采用多种手术和非手术技术进行处理,包括使用半封闭敷料。

目的

本系统评价的目的是评估半封闭敷料用于指尖截肢的有效性和安全性。

方法

根据系统评价和Meta分析的首选报告项目(PRISMA)指南进行系统评价。检索了以下数据库:Medline、Embase和CINAHL。主要结局包括愈合率和上皮化时间。次要结局包括患者满意度、手指活动范围(ROM)、患者报告结局指标(PROMs)、指尖感觉、手术干预需求和并发症。

结果

共有15项研究符合纳入标准,涉及总共611例指尖截肢病例。总体平均愈合率为97.4%,完全上皮化的平均时间为30天。93%的患者实现了完全的活动范围。96.5%的患者报告对其结局感到满意或非常满意。平均重返工作时间为22.3天。31%的患者报告出现并发症,其中大多数被认为是轻微的。仅1.5%的患者需要手术干预。

结论

对于无骨外露的指尖截肢患者,半封闭敷料疗法是一种安全有效的治疗方式。需要进一步的比较研究来明确半封闭敷料在指尖截肢中的作用和方案。

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