Functional and Aesthetic Evaluation of Finger Injuries

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Dr. Vaibhav Jain*,Shivi Jain,Pradeep Jain,Tibar Banerjee, “Functional and Aesthetic Evaluation of Finger Injuries”, ijmhs, vol. 9, no. 7, pp. 523–534, Jul. 2019.
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Abstract

Finger injuries are one of the common problems presenting in any plastic
surgery emergency and are often neglected [1]. Here we share our experience
of treating finger injuries in the setting of a tertiary care centre in
government sector in India. We managed 50 patients in our hospital and did
various surgical (split thickness skin graft, flaps) or non-surgical procedures
on the patient’s according to the patient demand and situation. Healing by
secondary intention was best for small wounds of less than 1cm2,in terms of
cosmesis and function. Local advancement flaps proved better for larger
wounds.
Keywords: Finger injuries, STSG(split thickness skin graft), flaps, healing,
wounds

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References

1.Sorock GS. Acute traumatic occupationalhand injuries: Type, location, andseverity. J. Occup. Environ. Med. 2002;44: 345. 2.Yu YD, Zhang YZ, Bi WD and Wu T.Functional sensory function recovery ofrandom-pattern abdominal skin flap in therepair of fingertip skin defects. Experimental and Therapeutic Medicine 2013; 5: 830-4. 3.ChungKC, Pillsbury MS, Walters MR, Hayward RA. Reliability and validity testing of the Michigan Hand Outcomes Questionnaire. J Hand Surg Am. 1998 Jul;23(4):575-87. 4.Mennen U and Wise A. Fingertip injuriesmanagement with semiocclusive dressing.J. Hand Surg. (Br.) 1993; 18: 416. 5.Ipsen T, FrandsenPA and Barfred T.Conservative treatment of fingertipinjuries. Injury 1987; 18: 203. 6.RohrichRJ and Antrobus SD. Volaradvancement flaps.In W. F. Blair (Ed.),Techniques in Hand Surgery. Baltimore:Williams & Wilkins, 1996. Pp. 39–47. 7.Jeon BJ, Yang JW, Roh SY, Ki SH, LeeDC, Kim JS. Microsurgical reconstructionof soft-tissue defects in digits. Injury 2013; 44(3): 356-6073. 8.Sun W, Wang Z, Qiu S, Gaun S, Hu Y,Zhu L, Liu P. Repair of soft-tissue defectson volar aspect of fingers with medialplantar venous flap. Chin J Repar andReconstrSurg 2010; 24(1): 50-2. 9.Zhang W, Zhang W, Jiao C, Liu Y. Repairof finger soft-tissue defect with island flapbased on vascular chain of cutaneousbranch of dorsal metacarpal artery. Chin JRepar and ReconstrSurg 2013; 27(4):440-2.18. 10.Holm A and Zachariae L. Fingertip lesion:An evaluation of conservative treatmentversus free skin grafting. ActaOrthop.Scand. 1974; 45: 382 11.Davis SL, Shibasaki M, Low DA et al.Impaired Cutaneous Vasodilation andSweating in Grafted Skin During Whole-Body Heating. J Burn Care Res. 2007;28(3): 427–34. 12.Nishikawa H and Smith PJ. The recoveryof sensation and function after cross-finger flaps for fingertip injury. J. Hand Surg. (Br.) 1992; 17: 102 13.Li KW, Liu J, Liu MJ, Xie SL, Liu CX.Free multilobed posterior interosseousartery perforator flap for multi-finger skindefect reconstruction. JPlastReconstrAesthet Surg. 2015; 68: 9e16 14.Polatkan S, Orhun E, Polatkan O,Nuzumlali E and Bayri O. Evaluation ofthe improvement of sensibility afterprimary median nerve repair at the wrist.Microsurg 1998;18 : 192-6 15.Chow SP and Ho E. Open treatment offingertip injuries in adults. J. Hand Surg.(Am.) 1982; 7: 470 16.Schliephake H, Schmelzeisen R, NeukamFW. Long-term results of blood flow andcutaneous sensibility of flaps used for thereconstruction of facial soft tissues. J OralMaxillofacSurg 1994;52 :1247-52. 17.Waris T, Astrand K, Hamalainen H, et al.Regeneration of cold, warmth and heat-pain sensibility in human skin grafts. Br JPlastSurg 1989; 42: 576. 18.Grabb WC. Basic techniques in plasticsurgery (skin grafts). In: Grabb andSm ’ P Surgery, 3rd ed, Boston,Little Brown, 1979 19.Haro JJ, Del Valle ME, Calzada B, et al.Human glabrous skin autografts partiallyreinnervated without sensory corpuscles.An immunohistochemicalstudy.Scand JPlastReconstr Hand Surg 1994; 28: 25. 20.Stella M, Calcagni M, Teich-Alasia S, etal. Sensory endings in skin grafts andscars after extensive burns. Burns 1994;20: 49121.Ackerley R, Carlsson I, Wester H,Olausson H, Backlund Wasling H. Touchperceptions across skin sites: differencesbetween sensitivity, directiondiscrimination and pleasantness. FrontBehav Neurosci. 2014 Feb 19;8:54. doi:10.3389/fnbeh.2014.00054. PubMedPMID: 24600368; PubMed CentralPMCID: PMC3928539.

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References

1.Sorock GS. Acute traumatic occupationalhand injuries: Type, location, andseverity. J. Occup. Environ. Med. 2002;44: 345.
2.Yu YD, Zhang YZ, Bi WD and Wu T.Functional sensory function recovery ofrandom-pattern abdominal skin flap in therepair of fingertip skin defects.
Experimental and Therapeutic Medicine 2013; 5: 830-4. 3.ChungKC, Pillsbury MS, Walters MR, Hayward RA. Reliability and validity testing of the Michigan Hand Outcomes Questionnaire. J Hand Surg Am. 1998 Jul;23(4):575-87.
4.Mennen U and Wise A. Fingertip injuriesmanagement with semiocclusive dressing.J. Hand Surg. (Br.) 1993; 18: 416.
5.Ipsen T, FrandsenPA and Barfred T.Conservative treatment of fingertipinjuries. Injury 1987; 18: 203.
6.RohrichRJ and Antrobus SD. Volaradvancement flaps.In W. F. Blair (Ed.),Techniques in Hand Surgery. Baltimore:Williams & Wilkins, 1996. Pp. 39–47.
7.Jeon BJ, Yang JW, Roh SY, Ki SH, LeeDC, Kim JS. Microsurgical reconstructionof soft-tissue defects in digits. Injury 2013; 44(3): 356-6073.
8.Sun W, Wang Z, Qiu S, Gaun S, Hu Y,Zhu L, Liu P. Repair of soft-tissue defectson volar aspect of fingers with medialplantar venous flap. Chin J Repar andReconstrSurg 2010; 24(1): 50-2.
9.Zhang W, Zhang W, Jiao C, Liu Y. Repairof finger soft-tissue defect with island flapbased on vascular chain of cutaneousbranch of dorsal metacarpal artery. Chin JRepar and ReconstrSurg 2013; 27(4):440-2.18.
10.Holm A and Zachariae L. Fingertip lesion:An evaluation of conservative treatmentversus free skin grafting. ActaOrthop.Scand. 1974; 45: 382
11.Davis SL, Shibasaki M, Low DA et al.Impaired Cutaneous Vasodilation andSweating in Grafted Skin During Whole-Body Heating. J Burn Care Res. 2007;28(3): 427–34.
12.Nishikawa H and Smith PJ. The recoveryof sensation and function after cross-finger flaps for fingertip injury. J. Hand Surg. (Br.) 1992; 17: 102
13.Li KW, Liu J, Liu MJ, Xie SL, Liu CX.Free multilobed posterior interosseousartery perforator flap for multi-finger skindefect reconstruction. JPlastReconstrAesthet Surg. 2015; 68: 9e16
14.Polatkan S, Orhun E, Polatkan O,Nuzumlali E and Bayri O. Evaluation ofthe improvement of sensibility afterprimary median nerve repair at the wrist.Microsurg 1998;18 : 192-6
15.Chow SP and Ho E. Open treatment offingertip injuries in adults. J. Hand Surg.(Am.) 1982; 7: 470
16.Schliephake H, Schmelzeisen R, NeukamFW. Long-term results of blood flow andcutaneous sensibility of flaps used for thereconstruction of facial soft tissues. J OralMaxillofacSurg 1994;52 :1247-52.
17.Waris T, Astrand K, Hamalainen H, et al.Regeneration of cold, warmth and heat-pain sensibility in human skin grafts. Br JPlastSurg 1989; 42: 576.
18.Grabb WC. Basic techniques in plasticsurgery (skin grafts). In: Grabb andSm ’ P Surgery, 3rd ed, Boston,Little Brown, 1979
19.Haro JJ, Del Valle ME, Calzada B, et al.Human glabrous skin autografts partiallyreinnervated without sensory corpuscles.An immunohistochemicalstudy.Scand JPlastReconstr Hand Surg 1994; 28: 25.
20.Stella M, Calcagni M, Teich-Alasia S, etal. Sensory endings in skin grafts andscars after extensive burns. Burns 1994;20: 49121.Ackerley R, Carlsson I, Wester H,Olausson H, Backlund Wasling H. Touchperceptions across skin sites: differencesbetween sensitivity, directiondiscrimination and pleasantness. FrontBehav Neurosci. 2014 Feb 19;8:54. doi:10.3389/fnbeh.2014.00054. PubMedPMID: 24600368; PubMed CentralPMCID: PMC3928539.

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