Lipo-Layering: A Serendipitous Step Toward a Non-Engineered, Regenerative Solution for Severe Fingertip Injuries.

Early human evidence such as case series or small samples is exploring possible benefits.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Reconstructing subtotal or total volar fingertip avulsions remains a complex challenge, particularly in the absence of replantation options. Traditional flap techniques may be contraindicated or associated with significant donor-site morbidity. We describe a simple, reproducible technique using autologous adipose tissue grafting combined with platelet-rich plasma (PRP) - a method we refer to as "lipo-layering" - for the treatment of severe pulp avulsion injuries with exposed bone, tendon, and joint.Initially conceived as a temporary biological dressing while awaiting definitive reconstruction, lipo-layering unexpectedly resulted in complete granulation and re-epithelialization without the need for further surgical intervention. Over a 15-month period, six patients with seven injured digits underwent one or two sessions of lipo-layering. All grafts integrated successfully, with full coverage achieved in less than six weeks. No flap procedures or secondary grafts were required. Functional outcomes were favorable: full proximal interphalangeal (PIP) and distal interphalangeal (DIP) joint extension in all cases, near-complete DIP flexion in five out of seven digits, and minimal pain or cold intolerance. Sensory recovery ranged from 1 to 2g monofilament threshold.These results suggest that lipo-layering offers a promising alternative to more invasive techniques for volar fingertip r

Evidence level

Early human evidence such as case series or small samples is exploring possible benefits.

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