Background: BTM has be used on a complement of wounds to aid reconstruction; 1 and may preclude the need for more complex reconstruction and increased morbidity. Once BTM has integrated wounds usually undergo second stage split thickness skin grafting (STSG). To the authors knowledge there have been no reports of the use of a full thickness skin graft (FTSG) onto integrated BTM. We describe a case report and show the safe and successful use of a FTSG onto BTM on a finger. We propose the use of FTSG on BTM increases dermal thickness and decreases wound contraction.2
Methods: Written consent was given by the patient for the use of clinical details and photos for publication and presentation. This RHD fit and well 24-year-old man sustained a volar degloving of his right middle finger from 2mm proximal to the DIPJ crease with exposed yet intact FDP tendon. He also sustained complex nailbed lacerations to index and ring fingers with no fractures identified on Xray.
Results: A series of clinical photos shows the excellent outcome this patient had after reconstruction of a fingertip degloving in a roller machine at work. He had 100% graft take and regained full composite range of motion comparable to the other side with two point discrimination of 9mm over the FTSG. There was pliability of the reconstruction and overall patient satisfaction.
Conclusion: This case reports demonstrates the safe and successful use of FTSG onto BTM for fingertip pulp reconstruction with a good clinical outcome and should be considered in the Plastic Surgeons’ reconstructive toolbox.
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