The Role of Urinary Bladder Matrix in Preserving Length and Function After Fingertip Injury.

Background: Fingertip injuries are an overwhelmingly common but potentially debilitating injury. Preservation of functional length with restoration of sensate, supple tissue is the primary goal of reconstruction. Urinary bladder matrix (UBM) can serve as a tissue regenerator and replacement that can be kept moist with a dual-layer dressing, reducing painful dressing changes to every 10 days.

Methods: A retrospective review was performed analyzing all patients treated with UBM for hand and finger injuries at a single institution between 2020 and early 2024. Patient demographics were recorded, including age, sex, level of injury, mechanism of injury, and prior treatments. Surgical outcomes, including time to wound healing, necessity of skin grafting, and postoperative complications, were collected.

Results: A total of 23 cases were identified. Mechanisms of injury included traumatic amputation/crush (n = 10), burn injury (n = 1), dog bite (n = 1), ballistic trauma (n = 1), cancer excision (n = 1), septic flexor tenosynovitis requiring debridement (n = 1), and ischemic necrosis (n = 8). All patients underwent surgical debridement followed by application of UBM. Six of 23 patients required secondary skin grafting to achieve full healing. The product was successfully used after preexisting infection in 3 cases. The average time to wound healing was 9.8 weeks (SD 3.4 wk).

Conclusions: Fingertip injuries represent a common but challenging reconstructive problem. UBM is a viable alternative to secondary intention healing for fingertip injuries and allows for regeneration of the soft tissue envelope and preservation of length.