preprints.org > medicine and pharmacology > surgery > doi: 10.20944/preprints202405.0823.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 13 May 2024 / Approved: 13 May 2024 / Online: 13 May 2024 (10:47:38 CEST)

Background: Fingertip injuries with volar pulp tissue defects are challenging to manage due to the complex anatomy and critical role of the fingertip in sensory and motor functions. Traditional surgical approaches are associated with donor site morbidity, prolonged immobilization, and suboptimal functional outcomes. This study aimed to evaluate the efficacy of a conservative treatment protocol using artificial dermis and semi-occlusive dressing for these injuries. Methods: A single-center, prospective study was conducted on 31 patients with fingertip injuries involving volar pulp defects. The treatment protocol involved wound debridement, application of artificial dermis (Pelnac®), and semi-occlusive dressing (IV3000®). Outcomes were assessed using subjective questionnaires and objective measures, including fingerprint regeneration, sensory function, pain, and cosmetic appearance. The impact of injury characteristics on outcomes and treatment duration was evaluated. Complications were recorded, and patient satisfaction was assessed. Results: The mean treatment duration was 45.29 days (SD=17.53), with no significant differences based on injury characteristics. Complications were minimal, with only one case (3.22%) directly attributable to the treatment. Fingerprint regeneration was considerable (mean score=2.58, SD=0.67), with slightly better scores in bone-exposed injuries. Sensory disturbances were minimal, with no significant differences across injury types. Post-treatment pain was low (mean=0.45, SD=0.67), and cosmetic satisfaction was high (mean=4.09, SD=0.94). Overall patient satisfaction was high (mean=4.41, SD=0.67), regardless of injury severity. Discussion: This study demonstrates the efficacy of a conservative approach using artificial dermis and semi-occlusive dressing for fingertip injuries with volar pulp defects. The treatment protocol achieved favorable outcomes in tissue regeneration, sensory recovery, pain management, and cosmetic appearance while minimizing complications and morbidity associated with traditional surgical interventions. The high patient satisfaction across all injury types highlights the patient-centered nature of this approach. Conclusions: The conservative treatment protocol using artificial dermis and semi-occlusive dressing is a promising strategy for managing fingertip injuries with volar pulp defects. This approach harnesses the body's regenerative potential, minimizes surgical morbidity, and achieves excellent functional and aesthetic outcomes. Further research is needed to optimize treatment protocols and investigate long-term outcomes.

Artificial dermis; Fingertip; Fingerprint; Pelnac; Reconstruction; Regeneration; Semi-occlusive; Volar

Medicine and Pharmacology, Surgery

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