Traumatic digital injuries are the commonest type of wound presents to the A&E department.1 Dressing materials we used currently include simple gauze dressings with or without petrolatum tulles. However, these dressing materials are very greasy and tend to stick onto the wound surface causing pain and trauma on patients. Therefore, James 2 and Benbow3 suggested that they do not provide an ideal environment for healing. Other dressing materials that are more sophisticated include Hydrocolloid dressing and Lipido-Colloid dressing. Although these materials are low-adherent in nature 3 , nevertheless, it may not completely fit the contour of the digits particularly hydrocolloid dressing. In addition, periodical dressing is still required which cause pain, inconvenience, time and also costly for the patients.
On the other hand, an occlusive dressing material called the Hyphecan (the finger tip cap) has been used in the treatment of finger injuries in China for years.5, 6, 7, 8 Hyphecan is made from a derivative of chitin extracted from the shell of lobsters, shrimps and crabs .9 It is non-antigenic and causes no adverse systemic reaction.9 It can be used for finger injuries with bony exposure of up to 0.5cm .5 Application is simple, the Hyphecan finger tip cap is pulled over the injured fingertip and covered with gauze and bandage for protection.6 When the Hyphecan finger cap is applied, a fluid-surface junction is formed between the wound and the cap. When the exudates from the wound is reduced, gel-like fibronectin remains, which is essential to promote wound healing.10 The greatest advantage of Hyphecan is that it can be left intact on the wound unless it is broken or wound infection. As a result, patient does not need to return for daily dressing and thus minimize the pain during dressing. Time required for wound management is also reduced. Moreover, cost of the hyphecan is relatively cheaper when compared with other sophisticated dressing materials. Patient can manage the finger cap easily with follow-up every 1-2 weeks.6 The average healing time was about 4-5 weeks in various studies.6, 7 , 8 , 9 ,10
In conclusion, Hyphecan may be an alternative for treating traumatic finger injuries. However, current studies were mainly focused on the outcomes of using Hyphecan alone as dressing materials. Further comparative evaluations with other dressing materials are still required to support the clinical findings.
- Ma K.K., Chan, M. F. and Pang S.M.C. The Effectiveness of Using a Lipido-Colloid Dressing for Patients with Traumatic Digital Wounds.
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- James H. Wound dressings in accident and emergency departments.
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- Benbow M. Product Focus. Urgotul: Alternative to conventional non-adherence dressings. British Journal of Nursing 2002; 11: 135.
- Stone C. A., Wright H., Clarke T., Powell R. and Devaraj V.S. Healing at skin graft donor sites dressed with chitosan. British Journal of Plastic Surgery 1998; 53:601.
- 夏寧曉, 馬玉林, 岳思軍, 張巍, 梁志軍。 海膚康一期閉合法治療指端損傷47例。寧夏醫學雜志 1999; 3: 165。
- Ko C. H., Chan K. K. and Lee L. P. A Simple Occlusive Biological Dressing for Fingertip Injuries. Journal of Orthopaedic Surgery ROC 1997; 14: 64.
- 張軍。海膚康護創指套在手指遠端創傷中的應用研究。現代醫藥衛生2006; 17:2604。
- 鄒春錦，孫鳳翔，季祝永，張文祥，韓乃富。海膚康指套治療手指遠端缺損的體會。創傷外科雜誌2003; 5:398。
- Halim S. A., Stone C. A. and Devaraj V. S. The Hyphecan cap: a biological fingertip dressing. Injury 1998; 29: 261.
- Lee L. P., Lau, P. Y. and Chan C. W. A Simple and Efficient Treatment for Fingertip Injuries. Journal of Hand Surgery 1995; 20B:63.