Composite grafts for fingertip amputations: A systematic review protocol.

Amputation Composite graft Distal finger tip Reconstruction

Journal

International journal of surgery protocols
ISSN: 2468-3574
Titre abrégé: Int J Surg Protoc
Pays: England
ID NLM: 101758186

Informations de publication

Date de publication:
2019
Historique:
received: 31 12 2018
revised: 05 04 2019
accepted: 21 05 2019
entrez: 4 1 2020
pubmed: 4 1 2020
medline: 4 1 2020
Statut: epublish

Résumé

There is much debate in the hand surgery literature as to the management of fingertip amputations. Much research continues to be published in this area. Methods of reattachment include microsurgical and non-microsurgical (composite graft) replantation. The role of composite grafts lacks clarity in terms of outcomes, success rates and complications. Hence there is a need for an evidence synthesis, which can guide patient selection, the consent process and determine graft survival rates and functional outcomes to optimise patient outcomes. Search of the databases OVID MEDLINE, PubMed, EMBASE, SCOPUS, The Cochrane Library and clinical trial registries from inception using terms "fingertip" "digital tip" "digit" "finger" "thumb" "amputation" "replantation" "reattachment" "reimplantation" and "composite graft" as key terms with "AND" selected as a Boolean operator, limited to humans will be conducted by two independent researchers. The patient population will include adults and children. Studies will be included if they report: (1) primary data; (2) outcomes of 'composite grafts' or 'nonmicrosurgical replantations'; (3) graft survival, (4) 5 or more cases. Articles will be excluded if surgical techniques involve: (1) composite graft pocketing, or (2) microsurgical replantation or (3) additional flaps (pulp or local). Full exclusion and inclusion criteria are described within this protocol. Data extraction will include; demographic details, patient comorbidities, amputation nature and level, functional, and aesthetic outcomes, complications and need for secondary procedures. All data extracted will be cross-checked, and discrepancies resolved through consensus. This review will be published in a peer-reviewed journal and will be presented at national and international conferences to inform the practice of other clinicians.

Sections du résumé

BACKGROUND BACKGROUND
There is much debate in the hand surgery literature as to the management of fingertip amputations. Much research continues to be published in this area. Methods of reattachment include microsurgical and non-microsurgical (composite graft) replantation. The role of composite grafts lacks clarity in terms of outcomes, success rates and complications. Hence there is a need for an evidence synthesis, which can guide patient selection, the consent process and determine graft survival rates and functional outcomes to optimise patient outcomes.
METHODS METHODS
Search of the databases OVID MEDLINE, PubMed, EMBASE, SCOPUS, The Cochrane Library and clinical trial registries from inception using terms "fingertip" "digital tip" "digit" "finger" "thumb" "amputation" "replantation" "reattachment" "reimplantation" and "composite graft" as key terms with "AND" selected as a Boolean operator, limited to humans will be conducted by two independent researchers. The patient population will include adults and children. Studies will be included if they report: (1) primary data; (2) outcomes of 'composite grafts' or 'nonmicrosurgical replantations'; (3) graft survival, (4) 5 or more cases. Articles will be excluded if surgical techniques involve: (1) composite graft pocketing, or (2) microsurgical replantation or (3) additional flaps (pulp or local). Full exclusion and inclusion criteria are described within this protocol. Data extraction will include; demographic details, patient comorbidities, amputation nature and level, functional, and aesthetic outcomes, complications and need for secondary procedures. All data extracted will be cross-checked, and discrepancies resolved through consensus.
DISSEMINATION RESULTS
This review will be published in a peer-reviewed journal and will be presented at national and international conferences to inform the practice of other clinicians.

Identifiants

pubmed: 31897441
doi: 10.1016/j.isjp.2019.05.001
pii: S2468-3574(18)30033-0
pmc: PMC6921220
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1-4

Informations de copyright

© 2019 Published by Elsevier Ltd on behalf of Surgical Associates Ltd.

Déclaration de conflit d'intérêts

The authors have no competing interests to declare.

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Auteurs

Mimi R Borrelli (MR)

Hagey Laboratory for Pediatric Regenerative Medicine, Department of Surgery, Division of Plastic Surgery, Stanford University School of Medicine, Stanford, CA, United States.

Madeleine L Landin (ML)

King's College London, Guy's, King's and St Thomas' School of Medicine, Guy's Campus, Great Maze Pond, London SE1 9RT, United Kingdom.

Riaz Agha (R)

Plastic Surgery Department, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Rd, Chelsea, London SW10 9NH, United Kingdom.

Aina Greig (A)

Plastic Surgery Department, St Thomas' Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, United Kingdom.

Classifications MeSH