J Wound Manag Res.  2023 Feb;19(1):46-52. 10.22467/jwmr.2022.02264.

The Effect of Topical Normobaric Oxygen Therapy on Composite Graft Survival in Fingertip Amputation

• Lee KD
• Cha EC
• Lee J
• Yoon S
• Choi Y
• Cho J

• KMID: 2540018
• DOI: http://doi.org/10.22467/jwmr.2022.02264

Abstract

Background
Though composite grafting is an easy, simple treatment for fingertip amputation, it is known to have a low survival rate. To increase the likelihood of composite graft survival, various adjuvant therapies such as hyperbaric oxygen therapy, ice-cooling, or vasodilator agents have been used. In this study, we attempted to validate the hypothesis that topical normobaric oxygen therapy (tNBO) could improve composite graft survival in fingertip amputation.
Methods
Patients who sustained fingertip amputations and who were treated with composite grafting between January 2015 and July 2020 were included. The patients (n=154) were divided into two groups: those who received tNBO (n=102) and those who had not (n=52). The effect of tNBO on graft survival, survival rate by level of amputation, and risk factors of graft survival (age, smoking, time to surgery, diabetes mellitus, and crush-avulsion injury type) were examined.
Results
tNBO significantly increased composite graft survival (75.3% vs. 50%, P<0.001) in amputations distal to the nail base area. Among risk factors, time to surgery >5 hours (odds ratio, 48.6; P=0.001) and crush-avulsion injury type (odds ratio, 10.1; P<0.001) significantly decreased graft survival in both groups. Smoking decreased graft survival only in the non-tNBO group (odds ratio, 28; P=0.015), not in the tNBO-treated group.
Conclusion
tNBO increased composite graft survival in fingertip amputation distal to the nail base area. It can be helpful for composite graft survival in smokers.

Keyword

Graft survival; Amputation, traumatic; Finger injuries