Comparing Skin Grafts Harvested From Wrist With Those Harvested From Groin Region in Patients With Fingertip Injury: A Randomized Clinical Trial

Fingertip injuries are among the most prevalent hand injuries. The fingertip has important sensory and functional role. When the size of fingertip skin defect is large, full thickness skin grafting is necessary. There are several donor sites for obtaining skin graft; however, there is no study concerning the best region of harvesting skin graft compatible with the fingertip. This study was designed to compare the skin grafts harvested from wrist and groin for fingertip skin loss. Patients and A total of 72 patients in need of skin grafting were randomized to two group of 36 to receive skin graft harvested from the wrist or from the groin regions. The patients included 71 males and only one female patient who was in the wrist harvested group. All the patients were operated by one technique. The minimum follow-up period was 18 months. The grafted skin was evaluated clinically regarding two-point discrimination (TPD), light touch, ulcer, graft contracture, hair growth on the grafted skin, and color difference between the graft and recipient site, which was evaluated with photo analyzer in Photoshop software. The grafted skins were compared between groups. Clinically, TPD and light touch were better (lower thresholds) in the wrist group (P < 0.05). Moreover, The amount of skin contracture, color difference between grafted skin and recipient site, and hair follicle counts were less in the wrist group (P < 0.001). In both groups, there were no ulcer and fissuring. For fingertip injures, full thickness skin grafts harvested from the wrist have significantly better cosmetic and functional results including better TPD and light touch, less hair follicles, less color difference, and less contracture.