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Journal of the Korean Society for Surgery of the Hand 2012;17(1):9-15.
Published online March 1, 2012.
Finger Tip Composite Grafting Managed with Moist-Exposed Dressing
Daegu Son, Hojun Chu, Hyeonjung Yeo, Junhyung Kim, Kihwan Han
Department of Plastic and Reconstructive Surgery, Keimyung University School of Medicine, Daegu, Korea. handson@dsmc.or.kr
Abstract
Purpose
The purpose of this study was to determine whether keeping the wound moist improves the results of composite grafting of amputated fingertip. MATERIALS AND METHODS: Between 1997 and 2010, 93 patients with traumatic amputation of 100 digits have undergone composite finger tip graft. The hand was kept elevated and a topical antibiotics was frequently applied to avoid desiccation. Their ages ranged from 10 months to 73 years. We assessed the success rate based on age, amputation level, ischemic time and etiology.

Results
Of these 100 composite grafts, grafting had been successful in 65. Evaluation by age revealed that grafting had been successful in 13 of 18 fingers among patients less than 6 years old, in four of five fingers among those 6 to 15 years old and in 48 of 77 fingers among those 16 years of age and older. Assessment by level of amputation showed that grafting had been successful in 37 of 56 fingers amputated in zone I, in 12 of 19 fingers amputated in zone II and in 16 of 25 fingers amputated in zone III. No statistically significant differences in graft survival were found in relation to age, amputation level, ischemic time or type of amputation.

Conclusion
Our results demonstrate that composite finger tip graft in adult is feasible and a very high rate of survival is obtained. We believe that moist-exposed dressings should improve the success rate associated with fingertip composite grafting.
 
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