Extending the limits of fingertip composite grafting with moist-exposed dressing.

We introduced the concept of moist wound healing to extend the limits of fingertip composite grafting. In this retrospective study, we assessed the success of fingertip composite grafting with moist-exposed ointment dressing, which has been shown to maintain adequate moisture for optimal healing by frequent ointment application without the need for a secondary overlying dressing. We reviewed the outcome of composite graft replacement of 60 amputated fingertips in 56 consecutive patients over a period of 3 years and 3 months. Forty-two fingertips had survived completely and 18 had failed. Twelve of 15 fingers among patients younger than 15 years of age and 30 of 45 fingers among those 16 years of age and older had survived completely. We believe that our use of antibiotic ointment to maintain a moist environment was an important factor in improving the survival of composite grafts.