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. 2025 Dec 12:48:593-602.
doi: 10.1016/j.jpra.2025.12.004. eCollection 2026 Mar.

Occlusive dressings for fingertip amputations: Clinical outcomes, pulp regeneration, and dermatoglyphic recovery

Paul Zaoui  1 , Maurice Renom  1 , Francois Loisel  1 , Soline Vericel  1 , Laurent Obert  1 , Isabelle Pluvy  1
Affiliations

Occlusive dressings for fingertip amputations: Clinical outcomes, pulp regeneration, and dermatoglyphic recovery

Paul Zaoui et al. JPRAS Open. .

Abstract

Objectives: To evaluate the clinical and functional outcomes of fingertip reconstruction with conservative treatment using occlusive dressings up to zone 3.

Patients and methods: A retrospective monocentric study was conducted on 26 patients (28 fingers) who presented an amputation in zones 1, 2, or 3, treated with occlusive dressings. The evaluation included epidemiological data on the trauma, the number of dressings required, healing time, satisfaction, recovery of sensation, regeneration of dermatoglyphs, pulp trophicity, complications, and functional scores.

Results: At a mean follow-up of 11.8 months, healing was achieved in 4.2 weeks after an average of four dressings. Pulp trophicity was excellent or good in 96.4 % of cases. Finger mobility was fully preserved in 89.3 % of fingers. Complete or partial dermatoglyphic regeneration was observed in all patients. Sensitivity tested by Weber's test was reduced by 24 % (4.6 mm vs. 3.5 mm contralateral). Nail dystrophies were noted in 60.4 % of fingers, mainly following amputations in zone 3. Cold intolerance was reported in 35.7 % of fingers. Functional scores confirmed satisfactory recovery. Satisfaction was high. The most frequently reported inconvenience was odor occasionally reported despite the use of charcoal dressings.

Conclusion: Occlusive dressings represent a reliable, non-invasive, and reproducible alternative in fingertip amputations in zones 1 and 2. Despite limitations in zone 3, the aesthetic and functional outcomes justify its use as a first-line treatment. Dermatoglyphic regeneration is a real phenomenon, with both functional and legal implications. These results support occlusive dressing as a first-line management option for selected fingertip amputations.

Keywords: Dermatoglyphs; Fingertip injury; Fingertip reconstruction; Occlusive dressing.

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Conflict of interest statement

The authors declare that they have no competing financial interests for this article. Francois Loisel: Consultant for Medartis. Other affiliations: Arthrex, Evolutis, ZimmerBiomet and Elsevier. Laurent Obert: Consultant for Medartis, Evolutis, FX Solutions, Kérimédical, Branchet. Royalties from FX Solutions, Elsevier and Sauramps. Zaoui Paul, Maurice Renom, Soline Vericel and Isabelle Pluvy: No conflicts of interests.

Figures

Figure 1
Figure 1
Application of an occlusive dressing: the same method was used at each dressing change. Ideally, the dressing should not cover the proximal interphalangeal joint to allow finger mobility.
Figure 2
Figure 2
Comparison between healthy digit (left third finger) and injured digit (right third finger, zone 2 amputation) showing excellent pulp trophicity after three occlusive dressings.
Figure 3
Figure 3
Dermatoglyphic regeneration on the injured finger in four patients at more than 1-year post-trauma.
Figure 4
Figure 4
Comparison of healthy finger (right fourth finger) and injured finger (left fourth finger, zone 3 amputation) demonstrating claw nail deformity after five occlusive dressings.
See this image and copyright information in PMC

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