This study evaluated the composite graft survival rate in distal digital amputations with respect to injury type and amputation level. The knowledge about the etiology, distribution and mechanisms of these injuries will enable the development of preventive measures in this regard. These childhood injuries lead to significant functional, aesthetic and psychological sequelae in these patients. In childhood, hand injuries are quite frequent and fingertip injuries constitute the majority of these entities. While many of these injuries required surgical intervention, appropriate patients were treated with wound care and secondary wound healing. The most frequent type of injury was crush type injuries with a rate of 83.3%, and among crush type injuries, the most common mechanism was trapping of fingers in the doors or windows. Injury was most frequent at five years old patient group. It was determined that the most injured fingers were middle fingers in the 136 (38.4%) of the patients, followed by the ring finger (33.9%). It was observed that the right hand (65.3%) was much more vulnerable to the injury than the left hand (34.7%). In our study group, the male patients (54%) were more affected than the girls (46%). Patients were discharged on the same day.
All interventions were performed under local anesthesia at the emergency service department. These patients were studied concerning sex, injured hand and fingers, injury mechanism, injury zone, selected treatment modalities and complications. Their ages ranged from six months to 17 years. Of the 354 patients, 191 were boys and 163 were girls. This study aims to draw attention to fingertip injuries that are very common in childhood and to help developing preventive strategies.
The data were studied using etiology, demographics, treatment and complications. In this study, 354 pediatric cases were evaluated and treated at the emergency service department due to fingertip injuries in a four years period.
Brisk capillary refill skin#
After debridement, most of the soft tissue survived and 0.2×0.2 cm of skin defect was found, which was healed through secondary intention. After then, the amputee was grafted over the flap. Soft tissue island flap based terminal branch of the digital artery was transposed to cover the distal phalanx. The composite graft was inadequate due to the exposure of distal phalanx and defect of soft tissue. Replantation was not possible because of the soft tissue defect. There was a very small amputee, and soft tissue was extremely little inside. Some soft tissue was lost from the stump and the bone was exposed. Her fingertip of the right little finger was amputated stuck by the air purifier. We report a case of successful fingertip reconstruction in a 10-month-old girl using a subcutaneous island flap with a composite graft. Moreover, there are not many options if distal phalanx is exposed due to defects of soft tissue. The upper limit of normal for men was 2.0 sec- onds and 2.9 seconds for women.Reconstruction of amputated fingertips is extremely challenging when the amputee is very small and severely crushed. Median capillary refill times for adults were 1.0 seconds for men and 1.2 seconds for women. What is normal capillary refill in adults? Peripheral vasoconstriction is an appropriate response to low circulating blood volume and reduced oxygen delivery to vital tissues.Ĭonsequently, what does a brisk capillary refill mean?īrisk capillary refill is when blood returns to an area quickly after pressure has been applied. A CRT longer than 2 seconds suggests poor perfusion due to peripheral vasoconstriction.
Similarly, what causes poor capillary refill? Capillary refill time This is consistent with a normal blood volume and perfusion.
If there is good blood flow to the nail bed, a pink color should return in less than 2 seconds after pressure is removed. It is used to monitor dehydration and the amount of blood flow to tissue. The capillary nail refill test is a quick test done on the nail beds. Similarly one may ask, what is the purpose of a capillary refill? A prolonged capillary refill time may be a sign of shock and can also indicate dehydration and decreased peripheral perfusion. Capillary refill time (CRT) is defined as the time taken for color to return to an external capillary bed after pressure is applied to cause blanching.