title: [The semi-occlusive dressing in treating Allen III and IV fingertip injuries as an alternative to local skin flaps].
abstract: BACKGROUND
  Fingertip injuries are very common in emergency departments. According to the literature, Allen III and IV fingertip injuries should be treated with local skin flaps. Instead, we have treated these kinds of injuries in recent years with a semi-occlusive dressing. The main purpose of this study was to evaluate the outcome after semi-occlusive dressing therapy with respect to soft tissue cover, recovery of sensibility and duration of disability.
  
  
  METHODS
  We retrospectively analysed 77 fingertip injuries (39 Allen I, 25 Allen II, 9 Allen III, 4 Allen IV) from 2008-2011 in 23 women and 54 men who were treated with a semi-occlusive dressing. The mean age was 36 ± 14 years and the mean follow-up was seven months. The bone was not shortened even if the bone was exposed up to the wound level. The primarily occlusive dressing was left as long as possible and was sealed when necessary. Furthermore, the treatment time with the semi-occlusive dressing and the period of disability was recorded. Patient sensitivity recovery was also analysed.
  
  
  RESULTS
  The mean treatment duration was 21 ± 10 days and the mean duration of disability was 30 ± 17 days. The mean duration of disability was 19 ± 8 days for Allen I injuries, 36 ± 16 days for Allen II, 45 ± 20 days for Allen III and 58 ± 7 days for Allen IV. All patients developed satisfactory tissue cover and sensibility recovery. For amputation injuries of Allen III and IV, we recorded a normal light-touch 2‑point discrimination in the Semmes-Weinstein Test in 77 % and diminished in 23 %. There were no complications like tissue infections, neuroma or osteitis. Also, no secondary flap supply was necessary.
  
  
  CONCLUSIONS
  The semi-occlusive dressing is a good therapy for all kind of fingertip injuries, regardless of the amputation level. Even if the bone is exposed up to the wound level, satisfactory soft tissue cover can be achieved.
authors.affiliation: Abteilung für Unfallchirurgie, AUVA Unfallkrankenhaus Lorenz Böhler - European Hand Trauma Center, Donaueschingenstr. 13, 1200, Wien, Österreich. stefan.quadlbauer@auva.at.|Ludwig Boltzmann Institut für experimentelle und klinische Traumatologie, AUVA Research Center, 1200 Wien, Österreich. stefan.quadlbauer@auva.at.|Austrian Cluster for Tissue Regeneration, 1200 Wien, Österreich. stefan.quadlbauer@auva.at.
authors.forename: S
authors.initials: S
authors.lastname: Quadlbauer
authors.affiliation: Abteilung für Unfallchirurgie, AUVA Unfallkrankenhaus Lorenz Böhler - European Hand Trauma Center, Donaueschingenstr. 13, 1200, Wien, Österreich.
authors.forename: Ch
authors.initials: C
authors.lastname: Pezzei
authors.affiliation: Abteilung für Unfallchirurgie, AUVA Unfallkrankenhaus Lorenz Böhler - European Hand Trauma Center, Donaueschingenstr. 13, 1200, Wien, Österreich.
authors.forename: J
authors.initials: J
authors.lastname: Jurkowitsch
authors.affiliation: Abteilung für Unfallchirurgie, AUVA Unfallkrankenhaus Lorenz Böhler - European Hand Trauma Center, Donaueschingenstr. 13, 1200, Wien, Österreich.
authors.forename: T
authors.initials: T
authors.lastname: Beer
authors.affiliation: Abteilung für Unfallchirurgie, AUVA Unfallkrankenhaus Lorenz Böhler - European Hand Trauma Center, Donaueschingenstr. 13, 1200, Wien, Österreich.
authors.forename: T
authors.initials: T
authors.lastname: Keuchel
authors.affiliation: Abteilung für Unfallchirurgie, AUVA Unfallkrankenhaus Lorenz Böhler - European Hand Trauma Center, Donaueschingenstr. 13, 1200, Wien, Österreich.|Ludwig Boltzmann Institut für experimentelle und klinische Traumatologie, AUVA Research Center, 1200 Wien, Österreich.|Austrian Cluster for Tissue Regeneration, 1200 Wien, Österreich.
authors.forename: T
authors.initials: T
authors.lastname: Hausner
authors.affiliation: Abteilung für Unfallchirurgie, AUVA Unfallkrankenhaus Lorenz Böhler - European Hand Trauma Center, Donaueschingenstr. 13, 1200, Wien, Österreich.
authors.forename: M
authors.initials: M
authors.lastname: Leixnering
mesh_terms: D000328:Adult; D005260:Female; D005383:Finger Injuries / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
keywords: Amputation; Conservative treatment; Fingertip injury; Local skin flap; Semi-occlusive dressing