Analysis of Digital Ischemic Necrosis from Constrictive Finger Dressings: A Case Series

Abstract

Digital ischemic necrosis can result from circumferential compression by medical dressings or domestic materials, particularly in pediatric patients. We present nine cases of ischemic necrosis caused by constrictive finger dressings between 2014 and 2024. Seven cases were iatrogenic, related to medical dressings, and two were caregiver-induced. Caregiver-induced cases tended to show more severe injuries, often necessitating reconstructive procedures such as free flaps, and these patients generally presented later than those with iatrogenic injuries. The contrast in timing and severity between the two groups suggests that delayed recognition may contribute to less favorable outcomes. These cases highlight the preventable nature of this condition and emphasize the importance of early recognition, proper wound monitoring, and caregiver education to minimize tissue loss and reduce the need for complex reconstructive surgery.

Keywords

digital ischemia - necrosis - iatrogenic injury - free tissue flaps

Ethical Approval

The study was approved by the Institutional Review Board of Gwangmyeong Sungae Hospital (IRB number KIRB-2025-N-003) and performed in accordance with the principles of the Declaration of Helsinki.

Informed Consent

The patients provided written informed consent for the publication and the use of their images.

Publication History

Received: 04 March 2025

Accepted: 14 November 2025

Accepted Manuscript online:
18 November 2025

Article published online:
30 January 2026

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