右中指指尖部デグロービング損傷に対する袋型陰圧閉鎖療法による治療経験

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  • Treatment of Degloving Injury of Right Middle Finger Tip with Bag-Type Negative Pressure Dressing : A Case Report

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A degloving injury of the right middle finger tip was successfully treated using a bag-type negative pressure dressing (BNPD). The patient was a 5-year-old girl who injured her right middle finger with a fruit sorting machine. Injury was classified as zone II degloving injury, accompany with distal phalanx exposure.<br>After adequate debridement, using clean techniques, the wounds were covered with a hydrophilic polyurethane sponge. A drainage tube was placed on top of the sponge, and the whole region was covered with a film dressing. Then the hand was placed in a commercially available, gas sterilized, sealable bag. The mouth of the sealed bag was fixed to the forearm with film dressing to ensure a tight seal. The tube was connected to an aspirator and kept at negative pressure -15 to -17 kPa during rest periods. During therapeutic exercise of the fingers, aspiration was stopped and the negative pressure was reduced to enable the fingers to move freely.<br>Thirty-four days after starting the treatment, adequate granulation and wound regression were achieved and the BNPD was terminated. One week after termination of BNPD, the wound was almost epithelialized. At the last follow-up, 34 weeks after the injury, TAM was 100% in the middle finger and the regeneration of the nail was satisfactory.<br>The BNPD method allows an early rehabilitation and motion of the affected finger resulting in a reduction of joint and scar contracture. For that reason, the BNPD should be considered as a feasible treatment for the finger tip injury instead of the aluminum foil method, and the artificial dermis.

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