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One of the key surgical decisions is whether to replace the nail plate following nail bed repair. The aim of this RCT was to assess the clinical effectiveness and cost-effectiveness of nail bed repair with fingernail replacement\/substitution compared with repair without fingernail replacement.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A two-arm 1 : 1 parallel-group open multicentre superiority RCT was performed across 20 secondary-care hospitals in the UK. The co-primary outcomes were surgical-site infection at around 7 days after surgery and cosmetic appearance summary score at a minimum of 4 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Some 451 children presenting with a suspected nail bed injury were recruited between July 2018 and July 2019; 224 were allocated to the nail-discarded arm, and 227 to the nail-replaced arm. There was no difference in the number of surgical-site infections at around 7 days between the two interventions or in cosmetic appearance. The mean total healthcare cost over the 4 months after surgery was \u20ac84 (95 per cent c.i. 34 to 140) lower for the nail-discarded arm than the nail-replaced arm (P &amp;lt; 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>After nail bed repair, discarding the fingernail was associated with similar rates of infection and cosmesis ratings as replacement of the finger nail, but was cost saving. Registration number: ISRCTN44551796 (http:\/\/www.controlled-trials.com).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znad031","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T11:47:20Z","timestamp":1679485640000},"page":"432-438","source":"Crossref","is-referenced-by-count":21,"title":["Effectiveness of nail bed repair in children with or without replacing the fingernail: NINJA multicentre randomized clinical trial"],"prefix":"10.1093","volume":"110","author":[{"given":"Abhilash","family":"Jain","sequence":"first","affiliation":[{"name":"Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford , Oxford , UK"},{"name":"Department of Plastic Surgery, Imperial College Healthcare NHS Trust , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aina V H","family":"Greig","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Guy\u2019s and St 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