Finger Injuries Clinical Trial
Official title:
Clinical Trial on the Semi-occlusive Treatment of Traumatic Substance Defects of the Fingertip in Children and Adults With a Novel Silicone Finger Cap. ("Klinische Prüfung Zur Semiokklusiven Behandlung Von Traumatischen Substanzdefekten im Bereich Der Fingerendglieder Mittels Silikonfingerorthesen (Silikonfingelingen) Bei Kindern Und Erwachsenen")
Amputation injuries of the fingertip are common in all ages. For decades it is known that
conservatively treated fingertips can regenerate skin and soft tissues to form a functionally
and cosmetically excellent new fingertip. Unfortunately, little is known about the mechanisms
controlling this ability that, in humans, is confined to the fingertips. Even less is known
about the bacteria that regularly colonize these wounds without noticeable negative impact on
regeneration and healing. Medical evidence on fingertip regeneration in humans is largely
limited to retrospective studies and case reports. This study will be the first randomized
controlled trial on the conservative treatment of fingertip amputations in children and
adults.
When managed without surgery, self-adhesive polyurethane film dressings are commonly used to
establish a wet chamber around the injury. This provides the best conditions for tissue
regeneration inhibiting the formation of scar tissue at the same time. Unfortunately these
dressings do not offer mechanical protection, they do not stick to wet skin and leak
malodorous wound fluid. The investigators therefore developed a silicone finger cap that
deals with these problems offering a mechanically protected, wet chamber around the injury
for optimal regeneration conditions. This finger cap also offers a puncturable reservoir for
excess wound fluid, which by this route can be routinely analyzed for diagnostic and research
purposes.
This randomized controlled trial will for the first time test acceptance, safety and efficacy
of this novel medical device in comparison with conventional self-adhesive film dressings
while gathering information on the clinical course and outcome of conservatively treated
fingertip amputation injuries.
Based on sample size calculations for primary outcome, 22 patients older than 2 years will be
enrolled within 24 hours after having suffered an injury distal to the distal interphalangeal
joint comprising all layers of the skin with a substance defect that cannot be primarily
adapted without further shortening of the finger or plastic surgery. Participants are
randomly assigned to start their treatment for the first two weeks either with a conventional
film dressing or with the novel silicone finger cap. They will be changed to the other
modality for another two weeks before the patient or the guardian can decide, if they would
want the film dressing or the finger cap for the rest of the treatment.
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