Experience with semi occlusive dressing in fingertip injuries
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Transcript of Experience with semi occlusive dressing in fingertip injuries
Experience with semi-occlusive dressing in
fingertip injuries: a case series report.
Azocar C., Luna E., Liendo R., Henriquez L., Valenzuela M.
Background
Objectives
Patients & Method
Results
Conclusion
Background• Distal phalanx fractures with fingertip injuries are common in our practice
though there is still controversy concerning its treatment. • Semi-occlusive dressing has been used with good and excellent outcomes,
where achieved esthetical results and tactile discrimination is superior to those obtained with surgical treatment and without further complications.
• This technique is based on providing an ideal environment that stimulates cellular migration, proliferation and neoangiogenesis, accomplishing optimum functional results through a simple, inexpensive, and minimally invasive technique.
Objectives
• Describe our experience with semi-occlusive dressing.
o Evaluate esthetic and functional results.o Evaluate time until complete coverage of the fingertip.o Evaluate clinical tolerance of the semi occlusive dressing.
Patients & Method• Study design: Cohort study
• Patients Inclusion criteria
o Distal phalanx fracture, Allen classification zones 1, 2 and 3o Long finger lesions
Exclusion criteriao > 6 hours of evolutiono > 3 fingers involvedo Fractures that require osteosynthesiso Lack of capacity to follow instructionso Diabetes Mellitus without treatmento Active tabaquism
La Main traumatique. L'Urgence. Michel Merle, Gilles Dautel. 3ºedition. Elsevier Masson, 2011
.
Patients & Method• Patients included
o 6 patients were treated with this method during a 3 month period; all male between 40 and 65 years old. Injuries were caused by saw (4), knifes (1) and one animal attack.
• Methodo Patients were evaluated in the emergency department; a dose of antibiotics
(Cefazoline 2gr IV) and antitetanic vaccine were administrated before the procedure.
o Fractures were confirmed with plain radiographs.o Surgical debridement with saline solution was performed and then the semi-
occlusive dressing (Tegaderm® 3M) was installed.o Patients were controlled weekly for 6 weeks without changing the initial semi-
occlusive dressing. After 6 weeks, bandages were removed and granulatory tissue was cleaned and covered.
o A week later all bandages were removed and patients were encouraged to full range movement exercises.
o Patients were controlled 3 months later to evaluate final results with QuickDASH score and K Johnson satisfaction scale.
Patients & Method
Patients & Method
Patients & Method
3 weeks
Patients & Method
6 weeks 7 weeks
Results• Good and excellent functional results were obtained.
• QuickDash: Average 4,5Patient Score
1 Complete Satisfaction
2 Complete Satisfaction
3 Sastisfaction with minimal complaints
4 Complete Satisfaction
5 Complete Satisfaction
6 Complete Satisfaction
• K Johnson scale
• Time until complete coverage: 6 weeks.
• Excellent treatment tolerance.
Patient Score
1 0,0
2 4,5
3 15,9
4 6,8
5 0,0
6 0,0
Results• Satisfactory cosmetic results were achieved in all patients
with minimal residual pain, all patients presented full range of motion at 3 months. No complications were observed.
Results
Conclusion
This treatment appears as an alternative to skin flaps in patients with fingertip injuries. Excellent
cosmetic and functional results were achieved with a standardized protocol that can be reproduced.