Successful Delayed Amputated Split-Thickness Dermis Reattachment of a Fingertip Injury in the Home Setting without...

This case reports details a fingertip amputation injury. The patient was vitally stable post-injury and blood loss was controlled with direct pressure.

The injury was inspected and found to involve the finger pulp and nailbed, without exposure of the terminal phalanx (Allen 2).

The avulsed tissue was initially placed in situ at the site of the injury. At day 3 the viable dermis from the avulsed tissue was dissected away and a split-thickness dermal graft was performed. The graft was held in place with antibacterial dressings. Epithelialisation was complete at two weeks, sensation returned to normal at five months and progress was tracked with interval photography. Overall there was an excellent cosmetic and functional outcome.

Split-thickness grafting of the dermis has been previously described, but there are no reports of this technique being applied to fingertip injuries. De-epithelialisation may enhance the likelihood of graft survival when compared to composite grafting techniques.