Purpose
The aim of this study was to determine the efficacy and the results of occlusive dressing in treating fingertip injuries in comparison with V-Y flaps.
Patients and methods
The study was performed at Orthopedics and Traumatology Department, Assiut University Hospital, enrolling 44 patients with fingertip injuries: 22 patients in whom occlusive dressing was used and 22 patients in whom V-Y flap was done. The Arabic version of the Quick-Disability of Arm, Shoulder, and Hand score, occurrence of complications (infection, nail deformity, stiffness of the distal interphalangeal joint, and necrosis of the flap), time to return to work, finger length pulp volume, and sensory related outcomes (presence of neuroma, two point discrimination measurement, and cold discomfort) were compared between the two groups. The study was approved by Assiut Medical School Ethical Review Board, with approval Number 17100214 and registered at Clinical Trials Database by NCT03193983.
Results
The frequency of nail deformity and neuroma formation was significantly higher in case of V-Y flap in comparison with occlusive dressing group (45.5 vs. 13.6%, = 0.04 for nail deformity; 31.8 vs. 4.5%, = 0.04 for neuroma). Return to the work was significantly earlier in case V-Y flap [6 (4–8) weeks] vs occlusive dressing [9 (6–12) weeks] ( = 0.01).
Conclusion
This work showed that both occlusive dressing and V-Y flap are effective methods for treating fingertip injuries. Return to work and duration of treatment were much longer with occlusive dressing than with V-Y flap. Sensory and cosmetic outcomes were better with occlusive dressing than with V-Y flap.