Paediatric fingertip composite grafts: Do they all go black?

Area of Science:

• Pediatric surgery
• Hand surgery
• Regenerative medicine

Background:

• Fingertip injuries are common in children.
• Distal digital amputations require effective treatment strategies.
• Composite grafting is a potential solution for pediatric fingertip injuries.

Purpose of the Study:

• To evaluate composite graft survival in pediatric distal digital amputations.
• To assess the influence of injury type, amputation level, and time to surgery on graft outcomes.
• To determine the overall success rate and morbidity associated with composite grafting in children.

Main Methods:

• Retrospective review of 105 pediatric patients undergoing fingertip composite grafting over 11 years.
• Inclusion criteria: non-vascularized replantation of amputated fingertips; exclusion: missed follow-ups.
• Graft viability assessed as no take, partial take, or complete take; data on secondary procedures and follow-up recorded.

Main Results:

• 96 patients were included; 32% had no graft take, 52% partial take, and 16% complete take.
• Only 2% of patients required secondary revision surgery.
• Injury type, amputation level, and time to surgery did not significantly impact graft survival outcomes.

Conclusions:

• Over two-thirds of composite grafts in children demonstrated some degree of take, primarily partial.
• Composite grafting for pediatric fingertip injuries is associated with low morbidity.
• Most children undergoing this procedure did not require additional surgical interventions.