gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Treatment of fingertip injuries with the semi-occlusive dressing

Meeting Abstract

  • presenting/speaker Stefan Quadlbauer - AUVA Trauma Hospital Lorenz Böhler, Wien, Austria
  • Christoph Pezzei - AUVA Trauma Hospital Lorenz Böhler, Wien, Austria
  • Josef Jurkowitsch - AUVA Trauma Hospital Lorenz Böhler, Wien, Austria
  • Tina Keuchel - AUVA Trauma Hospital Lorenz Böhler, Wien, Austria
  • Rudolf Rosenauer - AUVA Trauma Hospital Lorenz Böhler, Wien, Austria
  • Thomas Beer - AUVA Trauma Hospital Lorenz Böhler, Wien, Austria
  • Thomas Hausner - AUVA Trauma Hospital Lorenz Böhler, Wien, Austria
  • Martin Leixnering - AUVA Trauma Hospital Lorenz Böhler, Wien, Austria

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-997

doi: 10.3205/19ifssh0248, urn:nbn:de:0183-19ifssh02489

Published: February 6, 2020

© 2020 Quadlbauer 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

Objectives/Interrogation: Injuries to the fingertips are very commonly encountered in the emergency department. V-Y plasty according to Tranquilli-Leali is a widely accepted approach for coverage of these defects in patients with an exposed distal phalanx.

The occlusive dressing was first reported on by De Boer and Collinson in 1981; finger stalls consisting of silver sulfadiazine and ointment were used at this time. The occlusive dressing has been developed further in the last 20 years. Mennen and Wiese were the first to use Opsite® foils in 1993. Briefer periods of incapacity for work and nearly complete restoration of sensitivity have been reported in studies. 1997 Vogt et al. observed markedly increased levels of growth factors and immunological factors in the wound exudate.

Methods: 114 fingertip injuries were treated with occlusive dressings between 2008 and 2011.

All fingertip injuries (purely soft tissue injuries and amputations with bone involvement) of the distal phalanx were debrided, cleaned with antiseptic, and an occlusive dressing made of Opsite® foil was placed.

Bone shortening was not required in any patient. The foils were placed fully on the flexor and the extensor side. After placement of the dressing the patients received a finger wrap-over dressing. The primary occlusive dressing was left in place as long as possible. It was sealed if necessary, and removed only after the wound had healed. Photographs were taken in two planes at weekly intervals until complete healing had been achieved. After the treatment had been concluded. The size of the defect was classified according to Allen. In each patient a Semmes-Weinstein test was performed.

Results: 114 patients were treated with an occlusive dressing. The patients' mean age was 39 years, the mean duration of treatment with an occlusive dressing 20 days. 33 women (29%) and 81 men (71%) were included in the study. Sufficient soft tissue coverage was achieved in all patients and nearly complete regeneration of the fingertip and excellent cosmetic results were achieved in all patients.

Complete restoration of sensitivity was observed on the Semmes-Weinstein test in all patients. No patient developed a soft tissue infection, neuroma, or osteitis, and no patient required a secondary flap plasty.

Conclusion: The semi-occlusive dressing is a good treatment option for all kind of fingertip injuries, regardless of the amputation level. Even if the bone is exposed up to the wound level, satisfactory soft tissue cover can be achieved.