A black finger does not equal a dead finger

• Main Authors: Shalimar Abdullah,, William H,, Levin KB,, Parminder GS,, Nur Azuatul AK,, Tan, JA, Ahmed Suparno BM,
• Format: Article
• Language: English
• Published: Pusat Perubatan Universiti Kebangsaan Malaysia 2018
• Online Access: http://journalarticle.ukm.my/20627/1/26_ms0247_pdf_62763.pdf; http://journalarticle.ukm.my/20627/; https://www.medicineandhealthukm.com/toc/13/2

Revascularisation and replant surgery occasionally produces sub-optimal results. We present two cases of near total amputation of the digits. The first patient was an 11-year-old boy with a middle finger avulsion injury sustained after the finger was caught in a washing machine with the flexor digitorum profundus still attached. The second patient was a 42-year-old male who sustained a machete attack and had near total amputation of his small and ring fingers with a 2 cm skin bridge still attached. All patients underwent revascularization with repair of only one digital artery for each finger as the opposite artery was non-viable. No digital veins were repaired. Relief of venous congestion was done by pin-prick six times a day up till one week. At one week post-surgery, the fingers were discoloured black but had good pulp turgor and full contour with arterial bleed on pin-prick. Inexperienced surgeons may view this as gangrene and amputate the fingers. However, we continued observation and at one month post-surgery, the black skin had desloughed and the underlying skin was pink.