Fingertip and Nailbed Injuries: Local Flaps-Treatment of nail bed avulsions with split-thickness nail bed grafts

Treatment of nail bed avulsions with split-thickness nail bed grafts

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This document discusses the treatment of nail bed avulsions using split-thickness nail bed grafts. The feasibility of this technique was confirmed through experimental studies using squirrel monkeys, where thin grafts from the nail bed achieved excellent results. In clinical studies, 31 patients with avulsion of segments of the nail bed were treated with split-thickness nail bed grafts. The injured nail bed was used as a donor site in most cases, while a split-thickness graft from the great toe was used in some others. Out of the 31 treated nail beds, only five exhibited deformities, while 26 had normal nails with no deformity. No deformities occurred in the donor area. The use of split-thickness nail bed grafts had several advantages, such as the frequent availability of tissue on the injured digit and the absence of donor site deformity. Other methods of treatment, such as rotation flaps and skin grafting, had inferior results. Full-thickness toenail grafts were also successful in restoring the nail bed, but they resulted in deformities in the donor area. The use of split-thickness nail bed grafts from the injured digit or the great toe is an effective technique for treating avulsions of the nail bed, providing normal nail regeneration and minimizing deformities.

Keywords

nail bed avulsions

split-thickness nail bed grafts

experimental studies

squirrel monkeys

clinical studies

donor site

great toe

deformities

rotation flaps

skin grafting