Unusual setting of medical care
Shigenori Masaki, Takashi Kawamoto
Department of Surgery and Gastroenterology, Miyanomori Memorial Hospital, Sapporo, Hokkaido, Japan
Am J Case Rep 2021; 22:e928950
Available online: 2021-01-16
Fingertip amputation injury is treated surgically or conservatively. Management strategies for these injuries vary depending on not only the site and the degree of tissue loss in the wound but also the country and region. Conservative management or revision amputation is common in the United States. On the other hand, operative management such as replantation or reconstruction is preferred in Japan; accordingly, a surgery is performed even in cases eligible for conservative management. Here, we report a case of fingertip amputation injury for which reconstructive surgery was recommended by a plastic surgeon, but the patient opted for conservative treatment, which was performed using moist wound dressings.
CASE REPORT: A 36-year-old woman suffered an Allen type III fingertip amputation injury with her right middle finger crushed in a thick iron door. The amputated fingertip was not retrieved. The plastic surgeon in charge initially recommended reconstructive surgery to the patient. However, the patient opted for conservative management; therefore, she visited the Wound Care Department in our hospital. Conservative treatment using moist wound dressings (Plus moist™) was performed, and the wound healed after 12 weeks, with outstanding aesthetic and functional results.
CONCLUSIONS: Conservative management with moist wound dressings can be a successful treatment modality for Allen type III fingertip amputation injury. In cases where the fingertip amputation injury can be treated using either surgery or conservative treatment, it is better to prioritize the patient’s wishes when selecting the treatment option.
Keywords: Amputation, Traumatic, Finger Injuries, Wound Healing, Wounds and Injuries