Composite grafts for fingertip amputations: a systematic review. Issue 1 (2nd January 2021)

• Record Type: Journal Article
• Authors: Landin, Madeleine L.; Borrelli, Mimi R.; Sinha, Vikram; Agha, Riaz; Greig, Aina V.H.
• Is Part Of: International journal of surgery short reports. Volume 6:Issue 1(2021)
• Page Start: e17
• Page End: e17
• Publication Date: 2021-01-02
• Subjects: Composite graft -- Distal fingertip -- Amputation -- Reconstruction; 617
• DOI: 10.1097/SR9.0000000000000017
• Languages: English
• ISSNs: 2468-7340

Abstract

Abstract : There is debate in the literature surrounding the management of fingertip amputations. The role of composite grafts lacks clarity in terms of outcomes and complications. Hence, there is a need for an evidence synthesis to guide practice. A search of the databases OVID MEDLINE, PubMed, EMBASE, SCOPUS, The Cochrane Library, and clinical trial registries was conducted, from 1946 to January 2020, using the key terms "fingertip, " "digital tip, " "digit, " "finger, " "thumb, " "amputation, " "replantation, " "reattachment, " "reimplantation, " and "composite graft." Studies reporting primary data on the outcomes of composite grafts of 5 or more digits were included. The studies included in this systematic review ranged in year of publication from 1959 to 2019. Data extraction included demographic details, functional, esthetic and adverse outcomes. Twenty-three articles were included. Outcome data on composite grafts are heterogeneous and little standardization of measurements exists, making interpretation challenging. Identified factors associated with improved outcomes include lower age, distal amputation levels by cut mechanism and decreased time to operation. Smoking is associated with poorer composite graft outcomes. Although survival rates vary greatly, composite grafting may be useful in certain cases and provide good functional and sensation outcomes with good patient satisfaction.