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Composite grafts for fingertip amputations: A systematic review protocol.

Mimi R Borrelli1, Madeleine L Landin2, Riaz Agha3

  • 1Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic Surgery, Stanford University School of Medicine, Stanford, CA, United States.

International Journal of Surgery Protocols
|January 4, 2020
PubMed
Summary

This systematic review synthesizes evidence on non-microsurgical composite grafts for fingertip amputations. It aims to clarify outcomes, success rates, and complications to guide clinical practice and patient selection.

Keywords:
AmputationComposite graftDistal finger tipReconstruction

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Area of Science:

  • Hand Surgery
  • Microsurgery
  • Regenerative Medicine

Background:

  • Management of fingertip amputations is debated, with microsurgical and non-microsurgical (composite graft) replantation as options.
  • The clinical utility of composite grafts for fingertip amputations requires clarification regarding outcomes, success rates, and complications.
  • An evidence synthesis is needed to guide patient selection, informed consent, and optimize outcomes for fingertip amputations.

Purpose of the Study:

  • To systematically review and synthesize evidence on the outcomes, success rates, and complications of non-microsurgical composite grafts for fingertip amputations.
  • To provide evidence-based guidance for patient selection and the consent process in managing fingertip amputations.
  • To determine graft survival rates and functional outcomes to optimize patient results.

Main Methods:

  • Comprehensive database search (OVID MEDLINE, PubMed, EMBASE, SCOPUS, The Cochrane Library) and clinical trial registries.
  • Inclusion of studies reporting primary data on composite grafts or non-microsurgical replantations with at least 5 cases in adult and pediatric populations.
  • Exclusion of studies involving composite graft pocketing, microsurgical replantation, or additional flaps; data extraction on demographics, amputation details, outcomes, and complications.

Main Results:

  • This section will detail the findings from the systematic review once completed.
  • Results will include quantitative and qualitative data on graft survival, functional outcomes, aesthetic results, and complication rates.
  • The review will identify factors influencing the success of composite grafts in fingertip amputations.

Conclusions:

  • The findings will elucidate the role and efficacy of non-microsurgical composite grafts in managing fingertip amputations.
  • This evidence synthesis will inform clinical decision-making, improving patient selection and consent processes.
  • Optimized management strategies based on this review are expected to enhance graft survival and functional outcomes for patients.