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KMID : 1143020190240040335
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Archives of Hand and Microsurgery
2019 Volume.24 No. 4 p.335 ~ p.344
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Surgical Outcomes of Cooling Composite Graft for Fingertip Amputation
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Lim Hyo-Seob
Tak Seung-Wan
Chung Chan-Min
Cho Sang-Hun
Lee Jong-Wook
Koh Sung-Hoon
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Abstract
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Purpose: This study aimed to report the surgical outcomes of postoperative management of ice-cooling combined with moist-open dressing and intravenous prostaglandin E1 (PGE1) injection. Ice cooling as postoperative management was also discussed.
Methods: Forty-one fingertip amputation of 38 patients between January 2007 and December 2017 were investigated retrospectively. Fingertip amputations were managed with postoperative ice bag application for 72 hours followed by moist open dressing and PGE1 injection.
Results: Twenty-five composite grafts (61.0%) survived with complete healing at 8 weeks after surgery, with favorable outcomes in cases with low injury level (type I, 82.3%) and guillotine injury (77.8%). A higher survival rate was significantly correlated with female sex, guillotine injury, injury without osseous tissue (type I), and cold outdoor temperature (p<0.05). Multivariate analysis revealed that differences between types I and III injuries, injury mode, and outdoor temperature were independent clinical parameters associated with composite graft survival.
Conclusion: The present study reported comparable results with postoperative ice cooling in cases with low injury level, guillotine injury, and low outdoor temperature. Prospective studies on the specific parameters of ice cooling and standards of manageable postoperative care should be conducted to enhance survival.
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KEYWORD
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Graft survival, Amputation stumps, Finger phalanges, Finger injuries, Tissue survival
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