Application of Multilayer Dermal Regeneration Templates in Fingertip and Nail Bed Reconstruction: A Retrospective Comparative Study.

BACKGROUND

Fingertip and nail bed injuries present a clinical challenge, requiring restoration of sensory, functional, and cosmetic integrity without donor-site morbidity. Multilayer dermal regeneration templates (DRTs), including Integra and Terudermis, offer a promising alternative to traditional flap techniques.

METHODS

This retrospective comparative study included 30 patients with Allen type I-III fingertip injuries treated at a tertiary medical center in Taiwan between January 2020 and December 2022. Reconstructions utilized Integra (n = 12) or Terudermis (n = 18). At 6 months, outcomes were assessed for wound-healing efficacy, cosmetic appearance, sensory recovery, functional restoration, and patient satisfaction. Data were analyzed using the Mann-Whitney U test and Fisher exact test (P < 0.05).

RESULTS

Both Integra and Terudermis achieved comparable outcomes (P > 0.05). Differences in finger length (0.37 cm) and nail bed area (0.34 cm2) were minimal. Vancouver Scar Scale scores ranged from 4 to 5. The mean 2-point discrimination on the affected side was 5.83 mm, with a 13.4% incidence of hook nail. Average distal interphalangeal joint range of motion was 79.0 degrees, and patient satisfaction averaged 4.8 out of 5. Complete epithelialization occurred within 38.9 days.

CONCLUSIONS

Multilayer DRTs are effective for fingertip and nail bed reconstruction, offering comparable healing efficiency, reliable sensory and functional recovery, and favorable cosmetic and patient-reported outcomes. Integra and Terudermis demonstrated comparable outcomes, supporting their use as viable, donor-site-free options in fingertip reconstruction.