FUNCTIONAL AND AESTHETIC OUTCOME AFTER SKIN COVER FOR FINGER TIP INJURIES, A PROSPECTIVE STUDY FROM CHENGALPATTU MEDICAL COLLEGE, INDIA

Selvan Ranganathan; Arul Mozhi Mangai A; Surya Rao Rao Venkata Mahipathy

Volume : VIII, Issue : IV, April - 2019

FUNCTIONAL AND AESTHETIC OUTCOME AFTER SKIN COVER FOR FINGER TIP INJURIES, A PROSPECTIVE STUDY FROM CHENGALPATTU MEDICAL COLLEGE, INDIA

Selvan Ranganathan, Arul Mozhi Mangai A, Surya Rao Rao Venkata Mahipathy

Abstract :

Background: Fingertip injuries are regarded as those distal to the insertions of the flexor and extensor tendons at the base of the distal phalanx. Primary goal of treatment is a painless fingertip with durable and sensate skin. We conducted a prospective study to evaluate the functional and aesthetic outcome after different types of skin cover for fingertip injuries in 34 patients during the period of November 2009 to December 2011. Methods: Wound healing characteristics, aesthetic appearance, sensory return, scar characteristics, quality of skin, patient acceptance, movements of finger joints and secondary procedures are assessed and univariate analysis was done. Results: Two patients had marginal flap necrosis,healed conservatively. Middle and index finger of right hand was the most commonly injured and most were men. Average two point discrimination was 4mm after v–y advancement flap and composite grafting, shortening and closure, 5mm after composite grafting, 6mm after Cross Finger Flap (CFF). Conclusions: Fingertip is appropriately managed considering the level and plane of injury, though Split Skin Graft (SSG) aids in closing the wound aesthetically it is inferior to second layer hythothenar graft. Smaller defects in children can be managed conservatively. Volar v–y advancement flap gives a good sensate tip and aesthetically better outcome compared to CFF.