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Semi-occlusive dressings for the management of fingertip amputations: A systematic review
Ali Esmaeil1, Abdulrahman O Al-Naseem1, Ali Lari1
1Orthopedic Departments, Al-Razi Orthopedic Hospital, Ministry of Health, Sulaibkhat, Jamal Abdel Nasser Street PO Box 5, 13001, Kuwait City, Kuwait.
Background:
Fingertip amputations can be managed using a number of surgical and nonsurgical techniques including semi-occlusive dressings.
Aim:
The aim of this systematic review is to assess the efficacy and safety of semi-occlusive dressings for fingertip amputations.
Methods:
A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The following databases were searched: Medline, Embase and CINAHL. The primary outcomes included healing rate and time to epithelialization. Secondary outcomes included patient satisfaction, finger range of motion (ROM), patient reported outcome measures (PROMs), fingertip sensitivity, need for surgical intervention and complications.
Results:
A total of 15 studies met the inclusion criteria with a total of 611 fingertip amputations. The mean overall healing rate was 97.4 % and the mean time to complete epithelialization was 30 days. Ninety three percent of patients achieved full ROM. A 96.5 % of patients reported being either satisfied or very satisfied with their outcome. Mean time to return to work was 22.3 days. Complications were reported in 31 % of patients, most of which were considered minor. Only 1.5 % of patients required surgical intervention.
Conclusion:
Semi-occlusive dressing therapy is a safe and effective treatment modality for patients with fingertip amputations without bone exposure. Further comparative studies are needed to outline the role and protocols of semi-occlusive dressings in fingertip amputations.
