Occlusive dressing versus local flap coverage for the treatment of fingertip amputations with exposed bone: a comparative study.

Laetitia Randazzo, Claire Muller, Colin Piessat, François Dap, Lionel Athlani
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Abstract

We retrospectively reviewed the outcomes of 54 patients treated with occlusive dressings (OD) (27 patients) or local flap (LF) coverage (28 patients) for fingertip amputations with bone exposure. All patients healed completely within a mean of 5 weeks in the OD group and 3.5 weeks in the LF group. At a mean follow-up of 26 months (range 12-38), 2-point discrimination was significantly better in the OD group (4 mm) than the LF group (6 mm). Proximal interphalangeal joint (PIP) stiffness was more common in the LF group, affecting one-third of patients. A cost analysis showed that ODs were 6.5 times less expensive than LFs performed in the operating theatre. OD appears to be a reliable and more cost-effective alternative to LF for treating zone 2 and 3 fingertip amputations with exposed bone, with similar healing time, better tactile discrimination and a lower rate of PIP joint stiffness.Level of evidence: IV.

在治疗骨外露的指尖截肢手术中,闭合性敷料与局部皮瓣覆盖的比较研究。
我们回顾性地分析了 54 位接受闭塞性敷料(OD)(27 位)或局部皮瓣(LF)覆盖(28 位)治疗的指尖截肢患者的疗效。OD组所有患者平均在5周内完全愈合,LF组平均在3.5周内完全愈合。在平均 26 个月(12-38 个月)的随访中,OD 组的 2 点辨别率(4 毫米)明显优于 LF 组(6 毫米)。近端指间关节(PIP)僵硬在 LF 组更为常见,影响到三分之一的患者。成本分析显示,OD 比在手术室进行 LF 的费用低 6.5 倍。在治疗2区和3区骨头外露的指尖截肢时,OD似乎是一种可靠且更具成本效益的替代LF的方法,具有相似的愈合时间、更好的触觉辨别能力和更低的PIP关节僵硬率:证据等级:IV。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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