A comparative study of patient outcome in treating fingertip amputation with semi-occlusive dressing and open dressing

Abstract

This is a single blinded prospective studies of 48 patients with fingertip amputation treated conservatively in Hospital Raja Perempuan Zainab II, Kota Bharu and IIUMMC, Kuantan, Pahang. The aim of this study to compare the outcome between semi-occlusive dressing and open dressing in traumatic fingertip amputation treated conservatively. There were 24 patients in each group of technique were selected and agreed to participate in this study. They were evaluated for the functional outcome with Michigan Hand Questionnaire score (MHQ), duration of healing time and complication arise from each type of dressing. 31 patients were male and most of them are Malay 79.2%. Mean age was 33.5 years old, range from 31 to 50 years old. Male were commonly affected with 64.6% while female 35.4%. Patient without comorbid 70.7% and others with comorbid. The middle finger most commonly injured with 37.5%, followed by index finger 18.8%, thumb 16.7%, little finger 14.6% and ring finger 12.5%. Injured side usually at the dominant hand 68.8% while non-dominant only 31.3%. Domestic injury represents in 52.1% cases followed by motor vehicle accident 27.1% and industrial injury 20.8%. In total of 48 patient, 38 patients came with wound size >1cm and another 10 patients with wound size <1cm. Mean of total MHQ score in semi-occlusive dressing is 96.06 while in open dressing 88.97 with statically significant different with p value 0.001. Each domain of MHQ scale in semi-occlusive dressing were showed >90 score while in open dressing only aesthetic domain showed score above 90. The mean of duration wound healing in semi-occlusive dressing were (26.95±) days while in open dressing were (34.65±) days with statistically has a significant difference with p value of 0.001. A total of 19 patients out of 48 develop complication with 7 patients in semi-occlussive dressing and 12 patients in open dressing. None of them develop cold intolerance or infection. As a conclusion, patients with semi-occlusive dressing have better functional outcome and duration of healing with evidence of statistically significant difference in both parameters.