Case Report
Volume 3 Issue 8 - 2020
Successful Reconstruction of Traumatic Finger Injury Using Integra® without Skin Graft during COVID-19 Crises
Ibraheem AlSawari1, Muneera Ben Nakhi2* and Nasser A Abdelall3
1Assistant Registrar, Department of Surgery, Adan Hospital, Ministry of Health, Kuwait
2Consultant Plastic Surgeon and Head of Plastic and Reconstructive Surgery Unit, Adan Hospital, Ministry of Health, Kuwait
3Assistant Registrar, Department of Internal Medicine, Adan Hospital, Ministry of Health, Kuwait
*Corresponding Author: Muneera Ben Nakhi, Consultant Plastic Surgeon and Head of Plastic and Reconstructive Surgery Unit, Adan Hospital, Ministry of Health, Kuwait.
Received: July 13, 2020; Published: July 27, 2020




Abstract

We report a case of middle-aged gentleman, who presented with delayed full thickness skin loss of the dorsal aspect of index of his dominant right hand. The defect was complex with exposed tendon of extensor indicis. Patient underwent a successful first stage reconstruction using Integra® dermal regeneration template. However, the standard second stage reconstruction with split-thickness skin graft was not carried because of COVID-19 pandemic crises, and the cancellations of all elective cases. To the best of our knowledge, this is the first reported case that describes successful reconstruction of complex finger injury using Integra® in single stage with no secondary coverage with split-thickness skin graft.

Keywords: Traumatic Finger Injury; Integra®; Skin Graft; COVID-19

References

  1. Valerio IL., et al. “Use of a Dermal Regeneration Template Wound Dressing in the Treatment of Combat-Related Upper Extremity Soft Tissue Injuries”. The Journal of Hand Surgery American 41.12 (2016): e453-e460. 
  2. APA Lucas., et al. “Application of Dermal Skin Substitutes for Hand and Finger Palmar Soft Tissue Loss”. Plastic and Reconstructive Surgery - Global Open 7 .11 (2019): e2551.
  3. Van Zuijlen PP., et al. “Dermal substitution in acute burns and reconstructive surgery: a subjective and objective long-term follow-up”. Plastic and Reconstructive Surgery 108 (2001): 1938-1946.
  4. Philandrianos C., et al. “Comparison of five dermal substitutes in full-thickness skin wound healing in a porcine model”. Burns 38 (2012): 820-829.
  5. Burke JF., et al. “Successful use of a physiologically acceptable artificial skin in the treatment of extensive burn injury”. Annals of Surgery 194.4 (1981): 413e428. 
  6. Yannas IV., et al. “Synthesis and characterization of a model extracellular matrix that induces partial regeneration of adult mammalian skin”. Proceedings of the National Academy of Sciences of the United States of America 86.3 (1989): 933e937.
  7. Stern R., et al. “Histologic study of artificial skin used in the treatment of full-thickness thermal injury”. The Journal of Burn Care and Rehabilitation 11.1 (1990): 7e13.
  8. Weigert R., et al. “Management of severe hand wounds with Integra dermal regeneration template”. The Journal of Hand Surgery European 36.3 (2011): 185e193.
  9. Demiri E., et al. “Reconstruction of skin avulsion injuries of the upper extremity with integra® dermal regeneration template and skin grafts in a single-stage procedure”. Archives of Orthopaedic and Trauma Surgery 133.11 (2013): 1521e1526. 
  10. Heimbach DM., et al. “Multicenter postapproval clinical trial of Integra dermal regeneration template for burn treatment”. Journal of Burn Care and Rehabilitation 24.1 (2003): 42e48. 
  11. Reynolds M., et al. “Use of Integra in the management of complex hand wounds from cancer resection and nonburn trauma”. Hand (N Y) 13.1 (2018): 74e79. 
  12. Saab IR., et al. “Treatment of a paediatric patient with a distal lower extremity traumatic wound using a dermal regeneration template and NPWT”. Journal of Wound Care 23.10 (2014): S5eS8.
  13. Graham GP., et al. “The use of Integra Dermal Regeneration Template in the reconstruction of traumatic degloving injuries”. Journal of Burn Care and Research 34.2 (2013): 261e266. 
  14. Ghazi BH and Williams JK. “Use of Integra in complex pediatric wounds”. Annals of Plastic Surgery 66.5 (2011): 493e496. 
  15. Heimbach D., et al. “Artificial dermis for major burns. A multi-center randomized clinical trial”. Annals of Surgery 208.3 (1988): 313e320.
  16. Rizzo M. “The use of Integra in hand and upper extremity surgery”. Journal of Hand Surgery American 37.3 (2012): 583e586. 
  17. Frame JD., et al. “Use of dermal regeneration template in contracture release procedures: a multicenter evaluation”. Plastic and Reconstructive Surgery 113 (2004): 1330-1338.
  18. Moiemen NS., et al. “Reconstructive surgery with a dermal regeneration template: clinical and histologic study”. Plastic and Reconstructive Surgery 108 (2001): 93-103.
  19. Dantzer E and Braye FM. “Reconstructive surgery using an artificial dermis (Integra): results with 39 grafts”. British Journal of Plastic Surgery 54 (2001): 659-664. 
  20. Faulhaber J., et al. “Long-term results after reconstruction of full thickness scalp defects with a dermal regeneration template”. Journal of the European Academy of Dermatology and Venereology 24 (2010): 572- 577.
  21. Johnson MB and Wong AK. “Integra-based Reconstruction of Large Scalp Wounds: A Case Report and Systematic Review of the Literature”. Plastic and Reconstructive Surgery, Global Open 4.10 (2016): e1074.
  22. Adani R., et al. “Use of integra artificial dermis to reduce donor site morbidity after pedicle flaps in hand surgery”. Journal of Hand Surgery American 39.11 (2014): 2228e2234.
  23. Jacoby S., et al. “One-stage Integra coverage for fingertip injuries”. Hand 8.3 (2013): 291e295.
Citation: Muneera Ben Nakhi., et al. “Successful Reconstruction of Traumatic Finger Injury Using Integra® without Skin Graft during COVID-19 Crises”. EC Clinical and Medical Case Reports 3.8 (2020): 36-42.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


April Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the April issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before April 26, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk