Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Treatment of Fingertip Amputation in Adults by Palmar Pocketing of the Amputated Part

  • Jung, Mi Sun (Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital) ;
  • Lim, Young Kook (Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital) ;
  • Hong, Yong Taek (Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital) ;
  • Kim, Hoon Nam (Department of Plastic and Reconstructive Surgery, Daegu Fatima Hospital)
  • Received : 2012.02.09
  • Accepted : 2012.05.07
  • Published : 2012.07.15
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Abstract

Background First suggested by Brent in 1979, the pocket principle is an alternative method for patients for whom a microsurgical replantation is not feasible. We report the successful results of a modified palmar pocket method in adults. Methods Between 2004 and 2008, we treated 10 patients by nonmicrosurgical replantation using palmar pocketing. All patients were adults who sustained a complete fingertip amputation from the tip to lunula in a digits. In all of these patients, the amputation occurred due to a crush or avulsion-type injury, and a microsurgical replantation was not feasible. We used the palmar pocketing method following a composite graft in these patients and prepared the pocket in the subcutaneous layer of the ipsilateral palm. Results Of a total of 10 cases, nine had complete survival of the replantation and one had 20% partial necrosis. All of the cases were managed to conserve the fingernails, which led to acceptable cosmetic results. Conclusions A composite graft and palmar pocketing in adult cases of fingertip injury constitute a simple, reliable operation for digital amputation extending from the tip to the lunula. These methods had satisfactory results.

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References

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  2. Thumb fingertip reconstruction with palmar V-Y flaps combined with bone and nail bed grafts following amputation vol.135, pp.4, 2012, https://doi.org/10.1007/s00402-015-2163-4
  3. External bleeding versus dermal pocketing for distal digital replantation without venous anastomosis vol.44, pp.2, 2012, https://doi.org/10.1177/1753193418817979