V-Y Flap Versus Occlusive Dressing in Treating Fingertip Injuries With Exposed Bone
Condition: Injury Arm
MeSH terms: Wounds and Injuries
Study type: Interventional

Summary: 
      Fingertip is a complex structure that is responsible for the fine function of the fingers and
      the whole hand. A fingertip injury is any soft tissue, nail or bony injury distal to the
      insertions of the long flexor and extensor tendons of a finger .Fingertip injury is a serious
      condition that if untreated properly could lead to significant functional disability and
      disuse of the injured finger. Up to date, defining the best treatment option for this injury
      remains controversial. Hand surgeons are divided between proponents of flap coverage and
      conservative treatment, driven by beliefs, training programs and financial aspects. After
      recently reviewing the literature for the current best evidence and fundamentals of
      conservative treatment, Krauss and Lalandei in their recent review of the literature, pointed
      out to the necessity for implementing controlled trials to compare both ways of treatment.
    

Detailed description: 
      The purpose of this study is to determine the efficacy and the results of occlusive dressing
      in treating fingertip injuries in comparison to flaps with much concern to certain factors
      that are closely related to our locality including patient compliance for regular follow up ,
      functional outcome , time to return to work and its socioeconomical impact and cosmetic
      results .

      Surgical group will undergo surgical coverage of the fingertip defect by V-Y flap using the
      skin on the volar aspect of the same finger designed as V shaped then mobilized dorsally to
      cover the defect and stitches to be Y shaped. Stitches are removed after 2 weeks.

      Conservative group will undergo minimal trimming of the bone end and an occlusive dressing
      that is changed on a weekly basis till complete healing of the defect that occurs after 6
      weeks
    

Intervention name(s): Flaps Coverage; Occlusive Dressing
Intervention type(s): Procedure; Procedure
Intervention description(s): Surgical group will undergo surgical coverage of the fingertip defect by V-Y flap using the skin on the volar aspect of the same finger designed as V shaped then mobilized dorsally to cover the defect and stitches to be Y shaped. Stitches are removed after 2 weeks.; Conservative group will undergo minimal trimming of the bone end and an occlusive dressing that is changed on a weekly basis till complete healing of the defect that occurs after 6 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: two groups Surgical group will undergo surgical coverage of the fingertip defect by V-Y flap using the skin on the volar aspect of the same finger designed as V shaped then mobilized dorsally to cover the defect and stitches to be Y shaped. Stitches are removed after 2 weeks.
Conservative group will undergo minimal trimming of the bone end and an occlusive dressing that is changed on a weekly basis till complete healing of the defect that occurs after 6 weeks.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: occlusive dressing