SPLIT-SKIN GRAFTS FROM HYPOTHENAR AREA FOR FINGERTIP AVULSIONS

Abstract

Fingertip loss is common in home and industrial injuries. Surgical treatment should be designed to produce the earliest healing with a resultant fingertip that is not tender, and which has good sensation and function. Fingertip loss, or avulsion, is almost a daily affair. Yet it takes from 30 to 90 days of spontaneous healing to return a patient to his job, and the end result may be tender with reduced function. For these reasons, plastic surgeons have been encouraging and teaching, since World War II, the use of split-skin graft repairs for avulsions and for granulating fingertips. By proper technique and early treatment, the patient should be using his hand on the 20th day. This paper suggests the use of the hypothenar eminence as a logical donor site for such grafts, simplifying the procedure and producing an excellent end result (Fig. 1). It works best where there is loss of fingertip skin and fat but, when indicated, one can use this method to repair skin losses elsewhere in the hand (Fig. 2).