Occlusive dressings for fingertip amputations: Clinical outcomes, pulp regeneration, and dermatoglyphic recovery

To evaluate the clinical and functional outcomes of fingertip reconstruction with conservative treatment using occlusive dressings up to zone 3.

A retrospective monocentric study was conducted on 26 patients (28 fingers) who presented an amputation in zones 1, 2, or 3, treated with occlusive dressings. The evaluation included epidemiological data on the trauma, the number of dressings required, healing time, satisfaction, recovery of sensation, regeneration of dermatoglyphs, pulp trophicity, complications, and functional scores.

At a mean follow-up of 11.8 months, healing was achieved in 4.2 weeks after an average of four dressings. Pulp trophicity was excellent or good in 96.4 % of cases. Finger mobility was fully preserved in 89.3 % of fingers. Complete or partial dermatoglyphic regeneration was observed in all patients. Sensitivity tested by Weber's test was reduced by 24 % (4.6 mm vs. 3.5 mm contralateral). Nail dystrophies were noted in 60.4 % of fingers, mainly following amputations in zone 3. Cold intolerance was reported in 35.7 % of fingers. Functional scores confirmed satisfactory recovery. Satisfaction was high. The most frequently reported inconvenience was odor occasionally reported despite the use of charcoal dressings.

Occlusive dressings represent a reliable, non-invasive, and reproducible alternative in fingertip amputations in zones 1 and 2. Despite limitations in zone 3, the aesthetic and functional outcomes justify its use as a first-line treatment. Dermatoglyphic regeneration is a real phenomenon, with both functional and legal implications. These results support occlusive dressing as a first-line management option for selected fingertip amputations.