gms | German Medical Science

132. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

28.04. - 01.05.2015, München

Novel silicon fingercap for semiocclusive treatment of fingertip injuries – A first series in pediatric patients

Meeting Abstract

  • Jurek Schultz - Universitätsklinikum C.G. Carus, Dresden, Klinik und Poliklinik für Kinderchirurgie, Dresden, Deutschland
  • Silvana Sußmann - Universitätsklinikum C.G. Carus, Dresden, Klinik und Poliklinik für Kinderchirurgie, Dresden, Deutschland
  • Percy Schröttner - Institut für Medizinische Mikrobiologie und Hygiene, Medizinische Fakultät Carl Gustav Carus TU Dresden, Dresden, Deutschland
  • Michael Haase - Universitätsklinikum C.G. Carus, Dresden, Klinik und Poliklinik für Kinderchirurgie, Dresden, Deutschland
  • Gabriele Hahn - Institut und Poliklinik für Radiologische Diagnostik, Medizinische Fakultät, Carl Gustav Carus, Dresden, Deutschland
  • Enno Jacobs - Institut für Medizinische Mikrobiologie und Hygiene, Medizinische Fakultät Carl Gustav Carus, Dresden, Deutschland
  • Guido Fitze - Universitätsklinikum C.G. Carus, Dresden, Klinik und Poliklinik für Kinderchirurgie, Dresden, Deutschland

Deutsche Gesellschaft für Chirurgie. 132. Kongress der Deutschen Gesellschaft für Chirurgie. München, 28.04.-01.05.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. Doc15dgch343

doi: 10.3205/15dgch343, urn:nbn:de:0183-15dgch3431

Published: April 24, 2015

© 2015 Schultz et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Introduction: Fingertip injuries are frequently seen in children. Incidence rates for hand injuries for children aged 0-6 years are indicated with up to 40 in 10000 per year. In more than one third of these cases fingertips are affected. Semiocclusive wound therapy has initially been promoted by pediatric surgeons. Although this treatment strategy using different occlusive dressings is being used for more that 30 years now, the underlying mechanisms supporting the regeneration process of the fingertip remain unclear. So far only little data exist suggesting a positive role of soluble factors and microorganisms for tissue regeneration.

Conventional occlusive dressings are sometimes difficult to apply, necessitate frequent changes of the dressings and are challenging due to the leakage of malodorous wound fluids leading to reduced patient compliance. Furthermore, conventional self adhesive films do not leave a defined, protected space around the injury to allow undisturbed tissue regeneration.

Material and methods: We designed a novel device for fingertip occlusion made of medical silicon which is easy to apply and comfortable to wear and therefore may be a significant improvement for the patient`s compliance. The novelty of our approach is a protected chamber around the fingertip which mimics the anatomical outlines of the uninjured fingertip and thus permits undisturbed regeneration. Additionally several capillaries and a reservoir were included which permit the controlled efflux of excess wound fluid. Therefore wound fluid leakage is kept to a minimum and excellent odor control is guaranteed. Additionally this reservoir allows non-traumatic access to the wound fluid during the regeneration process by aspiration of wound fluid.

Results: Here we report on a first series of 12 pediatric patients treated with individually fabricated silicon fingertips. All our patients were displaying excellent clinical outcomes both with regards to cosmetics and functionality. While microscopy of wound fluids indicated acute cellular inflammatory responses only in the first days of treatment, microbiological analysis of wound fluids showed a variety of both aerobe and anaerobe microorganisms that did neither lead to invasive infections nor to inhibited regeneration or suboptimal clinical outcomes.

Conclusion: In a prospective, randomized and controlled study with is supported by the german government (BMWi, Zentrales Innovationsprogramm Mittelstand, Förderkennzeichen KF3277901CR3) we will now try to evaluate and improve our novel fingertip orthesis in both pediatric and adult patients. Additionally we will try to make contributions to the understanding of the beneficial effect of semiocclusion for tissue regeneration by conducting both proteomic and microbiological analyses.