[Treatment of fingertip defect injuries with a semi-occlusive dressing]

In the treatment of substance loss of fingertips it is crucial to maintain functional length and to restore adequate sensibility. By treating those injuries with a semiocclusive dressing according to Mennen and Wiese (1993), we were able to achieve both goals with excellent results, avoiding the necessity of local or regional flaps as well as shortening of bone to achieve primary closure. 82 patients with 85 injured digits were treated either conventionally (primary closure with or without shortening of bone, vaseline gauze dressings: 31 digits) or with semiocclusive dressings (54 digits). 42 digits of the latter group with complete protocols were evaluated at the end of treatment. 26 digits with defects of skin and subcutaneous tissue of less than 1 cm2 to more than 2 cm2 necessitated an average of 18 days until complete healing (minimum 6, maximum 46 days). Eight digits with loss of skin, subcutaneous tissues and nailbed healed within 10 to 32 days (average 22 days) and eight digits in which defects included bone loss averaged 49 days for complete healing (37 to 64 days). No complications, especially no infections have been observed. All healed finger-tips were well padded, painless, many without visible scar and with static two-point discrimination between 2 and 8 mm.