{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T22:28:10Z","timestamp":1792708090284,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,4,4]],"date-time":"2016-04-04T00:00:00Z","timestamp":1459728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004694","name":"Kaohsiung Medical University","doi-asserted-by":"publisher","award":["KMU\u2010TP103G02, KMU\u2010TP103G04, KMU\u2010TP103G05, KMU\u2010TP104B07"],"award-info":[{"award-number":["KMU\u2010TP103G02, KMU\u2010TP103G04, KMU\u2010TP103G05, KMU\u2010TP104B07"]}],"id":[{"id":"10.13039\/501100004694","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Non\u2010replantable fingertip amputation is still a clinical challenge. We performed modified composite grafting with pulp adipofascial advancement flap for Hirase IIA fingertip amputations. Results from a series of patients are presented and achieved better outcome than traditional composite grafting. Patients and Methods: From September 2012 to April 2014, fourteen patients with sixteen digits were included in our study. Mean age of patients was 43.9 years (20\u201071 years). All of our patients underwent this procedure under digital block anesthesia. We performed pulp adipofascial advancement flap for better soft tissue coverage of bone exposure stump first. The amputated parts were defatted, trimming, and reattached as composite graft. Age and gender of patients, injured finger, Hirase classification, mechanism of trauma, overall graft survival area, two\u2010point discrimination (2PD) (mm) at six\u2010month, length of shortening of digit, The average disabilities of the arm, shoulder, and hand (DASH) score and subjective self\u2010evaluation questionnaire at 6 month were recorded. Results: Average graft survival area was 89% (75\u2010100%). Average length of shortening was 2.2 mm (1.8\u20103.5 mm). 2PD at six\u2010month after surgery was 6.3 mm in average (5\u20108 mm). Average DASH score at 6 month was 1.45 (0.83\u20102.5). The self\u2010evaluated aesthetic results showed twelve patients (85.7%) were very satisfied, and no patient was completely unsatisfied. Conclusions: In Hirase zone IIA traumatic fingertip amputation where replantation is difficult, our modified technique of composite grafting with pulp adipofascial advancement flap provided an alternative choice with high successful rate, acceptable functional and aesthetic outcomes. \u00a9 2016 Wiley Periodicals, Inc. Microsurgery, 2016. \u00a9 2015 Wiley Periodicals, Inc. Microsurgery 36:651\u2013657, 2016.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30051","type":"journal-article","created":{"date-parts":[[2016,4,4]],"date-time":"2016-04-04T06:12:57Z","timestamp":1459750377000},"page":"651-657","source":"Crossref","is-referenced-by-count":8,"title":["Composite grafting with pulp adipofascial advancement flaps for treating non\u2010replantable fingertip amputations"],"prefix":"10.1002","volume":"36","author":[{"given":"Hsin\u2010Ti","family":"Lai","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng\u2010Hua","family":"Wu","sequence":"additional","affiliation":[{"name":"Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Department of Anesthesia Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya\u2010Wei","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tung\u2010Ying","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su\u2010Shin","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Center for Stem Cell Research, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Department of Surgery, Faculty of Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui\u2010Min","family":"David Wang","sequence":"additional","affiliation":[{"name":"Center for Stem Cell Research, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Department of Fragrance and Cosmetic Science Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kao\u2010Ping","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery Kaohsiung Medical University Hospital, Kaohsiung Medical University Kaohsiung Taiwan"},{"name":"Department of Surgery, Faculty of Medicine, College of Medicine Kaohsiung Medical University Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sin\u2010Daw","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery 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