Nail bed grafting for the treatment of nail-complex injuries: A systematic review.

Introduction: Nail-bed grafting is an accepted treatment for nail-bed defects of the fingernail. This study summarizes and analyses recent data on the outcomes associated with nail-bed grafting for nail-bed injuries at varying degrees of severity.

Materials and methods: A literature search was conducted in the electronic databases(PubMed, MEDINE, EMBASE, SCOPUS) to extract articles published from March 1985 to March 2023. Studies reporting data on nail-bed injury treated with full or split thickness nail-bed grafting was included in the study. Extracted data consisted of demographic data, surgical technique, follow-up, outcomes and complications.

Results: A total of 107 articles were identified, of which 6 studies were eligible for final inclusion comprising a total of 84 patients. The average age of patients was 28.87 years. The mean length of follow-up was 17 months. 2 studies reported excellent outcome in 12 patients as per Zook's criteria. The first nail appeared 3 weeks to 4 months after the surgery. 4 studies mentioned use of nail splint after the surgery reflecting the current practice trends. No major complications were reported in the studies.

Conclusion: Nail-bed grafting can be a safe, effective technique for the treatment of nail-bed injuries in immediate and delayed setting. Results of nail-bed grafting indicate satisfactory outcome in carefully selected cohort of nail-bed injury patients.LEVEL OF EVIDENCE.V.