The Application of Small Intestinal Submucosa-Extracellular Matrix to Fingertip Injuries

To evaluate the clinical effectiveness of small intestinal submucosa-extracellular matrix (SIS-ECM) in the conservative treatment of traumatic fingertip injuries without residual tissue.

We conducted a retrospective analysis of 11 patients (12 fingers) treated with SIS-ECM between 2022 and 2024. No surgical reconstruction or skin grafting was performed. Wound size, exposed tissue, wound conditions, healing duration, scar quality, sensory recovery, and patient satisfaction were recorded. Scar formation was assessed using the Vancouver Scar Scale, and sensory outcomes were evaluated with the Semmes-Weinstein Monofilament Test (S-W test).

All wounds achieved complete epithelialization, with a mean healing time of 42.8 days (range, 26-71). Small defects (≤1.5 cm²) healed in an average of 34.3 days (about five weeks), while medium-sized defects (1.6-3.0 cm²) required slightly longer (39.2 days). In contrast, large defects (>3.0 cm²) showed markedly prolonged healing (60.0 days) and more pronounced scarring. Cases with bone exposure also demonstrated delayed healing and inferior scar quality. No cases required secondary surgical intervention, and overall patient satisfaction was high.

SIS-ECM appears to be a safe, effective, and minimally invasive alternative to skin grafting or flap procedures for fingertip injuries up to approximately 3 cm² or without bone exposure. However, larger defects or those with bone exposure may require careful consideration due to the risk of delayed wound closure and inferior cosmetic results. The findings should be interpreted with caution given the lack of a control group.