Paediatric fingertip composite grafts: Do they all go black?
Research article published in Journal of plastic, reconstructive & aesthetic surgery : JPRAS (2016)
Abstract
BACKGROUND: Fingertip injuries are amongst the most frequently seen hand injuries in the paediatric population. The present study evaluated the composite graft survival rate in distal digital amputations with respect to injury type, amputation level and time to surgery. METHODS: We performed a retrospective review of patients who underwent composite grafting of fingertip injuries over an 11-year period at a paediatric hospital. All children who underwent non-vascularized replantation of amputated fingertips were included. Patients were excluded if they failed to attend at least one follow-up appointment. Demographic information was recorded. The nature and level of injury and time to surgery was also recorded. Graft viability was characterized as no take, partial take, or complete take. The number of secondary procedures and number and duration of follow-up appointments were recorded. RESULTS: A total of 105 patients underwent fingertip composite grafting, of whom 96 were suitable for inclusion in this study. The median age was 2.4 years (0-16 years); there were 48 boys (46%) and 57 girls (54%). Thirty-one patients had no graft take (32%), 50 patients had partial take (52%) and 15 patients had complete take (16%). Only two patients underwent secondary revision (2%). The median number of follow-up appointments was 4, and the mean follow-up time was 68 days. Time to surgery or level of amputation did not have a statistically significant influence on outcome. CONCLUSIONS: Over two-thirds of composite grafts in children showed some degree of take, albeit partially in the majority. Morbidity was low, and most children did not require further surgery.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Fingertip injuries are amongst the most frequently seen hand injuries in the paediatric population.
Why This Matters for Hirudotherapy
This retrospective review over 11 years included 96 paediatric patients who underwent non-vascularized composite grafting of distal digital amputation injuries, finding that approximately two-thirds of grafts showed some degree of survival (partial or complete take), with low morbidity and only 2% requiring secondary revision. Time to surgery and amputation level did not significantly influence graft outcomes. While the topic of digital tissue salvage after injury is tangentially related to clinical settings where hirudotherapy is sometimes discussed, this study does not involve leeches, hirudotherapy, or any leech-derived agent, and the abstract does not specify what adjunctive measures, if any, were used. The relevance to ASH's domain is indirect at best.
Citation
Paediatric fingertip composite grafts: Do they all go black?
Murphy AD et al. · Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 2016
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