Arch Plast Surg.  2019 Nov;46(6):580-588. 10.5999/aps.2019.00997.

Long-term outcomes of nail bed reconstruction

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Gwangmyeong Sungae General Hospital, Gwangmyeong, Korea. drkim@korea.com

Abstract

BACKGROUND
There are various reconstructive options for nail bed defects. However, it is challenging not to leave a deformity. In this study, we investigated differences in outcomes depending on the reconstruction method, attempted to determine which method was better, and analyzed other factors that may affect outcomes.
METHODS
The long-term outcomes of nail bed reconstruction were reviewed retrospectively. We performed three types of reconstruction depending on the defect type: composite grafts of severed segments, nail bed grafts from the big toe, and two-stage surgery (flap coverage first, followed by a nail bed graft). Subsequent nail growth was evaluated during follow-up, and each outcome was graded based on Zook's criteria. The reconstruction methods were statistically analyzed. Other factors that could contribute to the outcomes, including age, the timing of surgery, germinal matrix involvement, defect size, and the presence of bone injuries, were also compared.
RESULTS
Twenty-one patients (22 digits) who underwent nail bed reconstruction were evaluated. The type of reconstruction method did not show a significant relationship with the outcomes. However, patients who sustained injuries in the germinal matrix and patients with a defect larger than half the size of the nail bed had significantly worse outcomes than the comparison groups.
CONCLUSIONS
The results suggest that no operative method was superior to another in terms of the outcomes of nail bed reconstruction. Nevertheless, involvement of the germinal matrix and defect size affected the outcomes.

Keyword

Finger injuries; Nails; Reconstructive surgical procedures; Surgical flaps

MeSH Terms

Congenital Abnormalities
Finger Injuries
Follow-Up Studies
Hallux
Humans
Methods
Reconstructive Surgical Procedures
Retrospective Studies
Surgical Flaps
Transplants
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