McCullough Meghan C, Ebner Peggy J, Brown Theodore, Williams Eva, Tanabe Kylie, Berihun Haben, Kuschner Stuart, Yacoubian Vahe, Kulber David A
From the Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, CA.
Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, CA.
Plast Reconstr Surg Glob Open. 2025 Sep 22;13(9):e7011. doi: 10.1097/GOX.0000000000007011. eCollection 2025 Sep.
Fingertip injuries are an overwhelmingly common but potentially debilitating injury. Preservation of functional length with restoration of sensate, supple tissue is the primary goal of reconstruction. Urinary bladder matrix (UBM) can serve as a tissue regenerator and replacement that can be kept moist with a dual-layer dressing, reducing painful dressing changes to every 10 days.
A retrospective review was performed analyzing all patients treated with UBM for hand and finger injuries at a single institution between 2020 and early 2024. Patient demographics were recorded, including age, sex, level of injury, mechanism of injury, and prior treatments. Surgical outcomes, including time to wound healing, necessity of skin grafting, and postoperative complications, were collected.
A total of 23 cases were identified. Mechanisms of injury included traumatic amputation/crush (n = 10), burn injury (n = 1), dog bite (n = 1), ballistic trauma (n = 1), cancer excision (n = 1), septic flexor tenosynovitis requiring debridement (n = 1), and ischemic necrosis (n = 8). All patients underwent surgical debridement followed by application of UBM. Six of 23 patients required secondary skin grafting to achieve full healing. The product was successfully used after preexisting infection in 3 cases. The average time to wound healing was 9.8 weeks (SD 3.4 wk).
Fingertip injuries represent a common but challenging reconstructive problem. UBM is a viable alternative to secondary intention healing for fingertip injuries and allows for regeneration of the soft tissue envelope and preservation of length.
指尖损伤极为常见，但可能导致功能障碍。保留功能长度并恢复有感觉、柔软的组织是重建的主要目标。膀胱基质（UBM）可作为一种组织再生和替代物，通过双层敷料保持湿润，将痛苦的换药间隔延长至每10天一次。
对2020年至2024年初在单一机构接受UBM治疗手部和手指损伤的所有患者进行回顾性分析。记录患者的人口统计学数据，包括年龄、性别、损伤部位、损伤机制和既往治疗情况。收集手术结果，包括伤口愈合时间、植皮必要性和术后并发症。
共确定23例病例。损伤机制包括创伤性截肢/挤压伤（n = 10）、烧伤（n = 1）、犬咬伤（n = 1）、弹道伤（n = 1）、癌症切除术后（n = 1）、因化脓性屈指肌腱鞘炎需清创（n = 1）和缺血性坏死（n = 8）。所有患者均接受手术清创，随后应用UBM。23例患者中有6例需要二期植皮才能完全愈合。该产品在3例既往有感染的病例中成功使用。伤口愈合的平均时间为9.8周（标准差3.4周）。
指尖损伤是一个常见但具有挑战性的重建问题。UBM是指尖损伤二期愈合的可行替代方法，可实现软组织包膜的再生并保留长度。
