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Journal of the Korean Society for Surgery of the Hand 2007;12(4):151-157.
Published online December 1, 2007.
Immediate Full-Thickness Nail Bed Graft with Various Skin Flaps for the Acute Nail Bed Defects of Fingertip Injuries
Se Kwan Oh, Yong Jig Lee, Young Keun Lee, Sang Hyun Woo
즉시 전층 조갑상 이식과 다양한 피판을 이용한 급성 수지 조갑상 결손의 재건
오세관, 이용직, 이영근, 우상현
Abstract
Purpose
We would like to report the effects of immediate full-thickness nail bed grafting in acute nail bed defects of fingertip injuries. Materials and Methods: From December 2003 to March 2007, 44 patients, who had acute nail bed defects in fingertip injuries, presented exposed distal phalangeal bone. The full-thickness nail bed grafts were obtained from injured amputees. The average size of graft was 15 mm2 (6~64 mm2). Also for covering soft tissue defects of fingertip, the authors performed cross-finger flaps in 20 cases, volar V-Y advancement flap in 17 cases, and 7 cases of thenar flaps. The operations were performed within almost 12 hours after the injury. Mean follow-up period was 13.8 months. Final follow-up and evaluation were done in 26 patients on the both functional and cosmetic aspects. Results: In final follow-up, there were excellent in 16 cases, good in 8 cases and fair in 2 cases. There were mild or moderate hyperesthesia in 17 cases, cold intolerances in 4 cases, mild hypersensitiveness in 2 cases, but most of them had little impairment in their habitual works. Conclusion: The immediate full-thickness nail bed graft with flap surgery is a feasible and useful method to get cosmetically functional nails after acute nail bed defect of fingertip injuries.
 
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