A deadly digital dressing: a case of surgical decompression for finger ischemia due to circumferential finger dressing

J Emerg Med. 2014 May;46(5):655-8. doi: 10.1016/j.jemermed.2013.09.035. Epub 2014 Jan 22.

Abstract

Background: Tubular gauze dressings are commonly used, but have potential to cause iatrogenic finger ischemia.

Objectives: To inform health care providers of an avoidable complication and to discuss appropriate methods of prevention and treatment.

Case report: We discuss a teenage female's finger that narrowly avoided amputation after a tubular gauze dressing caused iatrogenic ischemia. Surgical decompression using a novel technique successfully salvaged the finger. Operative intervention for this complication has previously been unreported.

Conclusion: It is important that circumferential digital dressings are applied correctly. Vascular insufficiency from an occlusive dressing is an iatrogenic and avoidable complication. Successful operative decompression may be indicated to minimize tissue loss and improve circulation.

Keywords: amputation; decompression; dressing; finger; ischemia.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Decompression, Surgical / methods*
  • Female
  • Finger Injuries / therapy*
  • Fingers / blood supply*
  • Humans
  • Ischemia / etiology*
  • Occlusive Dressings / adverse effects*
  • Treatment Outcome