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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(04): 310-319
DOI: 10.1055/s-0043-1771295
Systematic Review

Outcomes of Composite Grafts for Pediatric Fingertip Amputations: A Systematic Review

Noemi Jester   *
1   Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
2   Sheffield Medical School, Sheffield University, Sheffield, United Kingdom
,
Seunghee Han   *
3   Birmingham Medical School, Birmingham University, Birmingham, United Kingdom
,
Manwi Singh   *
1   Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
2   Sheffield Medical School, Sheffield University, Sheffield, United Kingdom
,
Avula Aishwarya Rao    *
1   Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
2   Sheffield Medical School, Sheffield University, Sheffield, United Kingdom
,
Balamrit Sokhal 
4   Keele Medical School, Keele University, Newcastle-under-Lyme United Kingdom
,
Yangmyung Ma 
1   Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
,
Andrea Jester
1   Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
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Abstract

Introduction The aim of this study was to explore the outcomes of composite grafts in fingertip amputations in children as well as the contributing factors that may affect outcomes.

Methods Literature search was conducted across six databases in March 2022 to select studies on the use of composite grafts on fingertip amputations in the pediatric population.

Results Twelve articles with 735 composite grafts were identified for review. Most fingertip injuries occurred in the less than 5-year age group and were due to crush type injuries. In studies that reported “complete” graft take as a separate outcome measure, 17.3% of fingertips with this result were observed. In the studies that reported “complete” and “partial” graft take together as an outcome measure, 81.6% of fingertips achieved this outcome. A lower proportion of failed graft take was observed in more distal fingertip amputations. Infection (3.8%) and nail abnormalities (3.4%) were the most common complications following composite grafting.

Conclusion Composite grafting can be considered as a useful method of treatment in this population. Clinicians should be aware of the potential complications following this method of treatment such as infection and nail abnormalities. More proximal fingertip amputations may warrant other surgical interventions (beyond Level II on the modified Ishikawa/Ishikawa classification). Significant heterogeneity was observed within the studies, mainly due to lack of standardization in assessment and reporting of outcomes.

Keywords

amputations - composite graft - fingertip - pediatric

Statement of Informed Consent

The authors declare that no identifiable patient data was used; therefore, informed consent was not applicable.


Statement of Human and Animal Rights

This article does not contain any studies with human or animal subjects.


Authors' Contributions

All authors made significant contributions to the work and can claim authorship according to the conditions posed.


* Co-first authors




Publication History

Article published online:
28 July 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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