Long-term follow-up of one-stage artificial dermis reconstruction surgery for fingertip defects with exposed phalanx

Abstract

Fingertip injuries are among the most common injuries of the hand. Although numerous treatment methods have been described in detail in the literature, there are a few alternatives that require exploration. We analyzed 24 patients who underwent one-stage artificial dermis (Pelnac®) reconstruction surgery between 2012 and 2016 to assess the effectiveness of this alternative reconstruction method for extensive fingertip injury with exposed phalanx. There were 16 males and 8 females, with ages ranging from 2 to 75 years. There were 16 type III injuries, 6 type IV, and 2 type II on the Allen classification. Complete epithelialization was achieved by the 4th week in 19 cases and by the 6th week in 5. The wounds of all patients healed completely, without infection. All the injured fingers developed various levels of hooked nail and length shortening except for the 2 type II injuries. There was nail spicule formation in 1 case. There were no cases of cold intolerance, but 2 cases of hypersensitivity and 5 of numbness. Overall 2-point discrimination ceased improving by the 2nd postoperative year. This technique is simple, allows spontaneous healing of the fingertips, and is mostly free from the major complications associated with other treatment methods.