Topical becaplermin improves outcomes in work related fingertip injuries.
BACKGROUND
Fingertip injuries are common and bear significant costs associated with treatment, lost work, and functional impairment. This study compared these factors in occupationally related fingertip injuries treated with becaplermin, a recombinant human platelet-derived growth factor, and those treated with surgical reconstruction.


METHODS
This was a prospective controlled trial involving occupationally related fingertip injuries. Fifty men (ages 23-51) with full thickness, single fingertip injuries > or =1.5 cm(2) with or without phalangeal exposure and distal to the distal interphalangeal (DIP) joint were evaluated. Group I (n = 25) underwent treatment with daily topical becaplermin. Group II (n = 25) underwent surgical reconstruction with a skin graft or local soft tissue flap. Time to wound healing, time to return to work, associated treatment costs, and calculated functional impairment were recorded.


RESULTS
Patients in Group I returned to work in significantly less time than those in Group II-10 days versus 38 days respectively). The average calculated functional impairment in Group I was 10% versus 22% in Group II. Associated treatment costs in group A were 1580 +/- 145 US Dollars compared with 6750 +/- 785 US Dollars in Group II. All differences were statistically significant at p < 0.05


CONCLUSIONS
In this study, the functional and economic costs were significantly less when fingertip injuries were treated with topical becaplermin than when they were treated with surgical reconstruction. This information should allow emergency and acute care physicians to treat these injuries more efficaciously and conveniently.
Freedman
Bruce M
BM
Plastic Surgery Associates of Northern Virginia LTD, McLean, USA. bfreedman58@aol.com
Oplinger
Elisabeth H
EH
Freedman
Irwin S
IS
D000062:Accidents, Occupational / Q000191:economics; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use*; D000077214:Becaplermin; D005383:Finger Injuries / Q000188:drug therapy* / Q000191:economics / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000188:drug therapy* / Q000191:economics / Q000601:surgery; D010982:Platelet-Derived Growth Factor / Q000627:therapeutic use*; D020574:Proto-Oncogene Proteins c-sis; D013997:Time Factors; D014945:Wound Healing
D000925:Anticoagulants; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; D000077214:Becaplermin