Application of Multilayer Dermal Regeneration Templates in Fingertip and Nail Bed Reconstruction: A Retrospective Comparative Study

Background: – Fingertip and nail bed injuries present a clinical challenge, requiring restoration of sensory, functional, and cosmetic integrity without donor-site morbidity. Multilayer dermal regeneration templates (DRTs), including Integra and Terudermis, offer a promising alternative to traditional flap techniques. Methods: – This retrospective comparative study included 30 patients with Allen type I–III fingertip injuries treated at a tertiary medical center in Taiwan between January 2020 and December 2022. Reconstructions utilized Integra (n = 12) or Terudermis (n = 18). At 6 months, outcomes were assessed for wound-healing efficacy, cosmetic appearance, sensory recovery, functional restoration, and patient satisfaction. Data were analyzed using the Mann-Whitney U test and Fisher exact test (P < 0.05). Results: – Both Integra and Terudermis achieved comparable outcomes (P > 0.05). Differences in finger length (0.37 cm) and nail bed area (0.34 cm2) were minimal. Vancouver Scar Scale scores ranged from 4 to 5. The mean 2-point discrimination on the affected side was 5.83 mm, with a 13.4% incidence of hook nail. Average distal interphalangeal joint range of motion was 79.0 degrees, and patient satisfaction averaged 4.8 out of 5. Complete epithelialization occurred within 38.9 days. Conclusions: – Multilayer DRTs are effective for fingertip and nail bed reconstruction, offering comparable healing efficiency, reliable sensory and functional recovery, and favorable cosmetic and patient-reported outcomes. Integra and Terudermis demonstrated comparable outcomes, supporting their use as viable, donor-site–free options in fingertip reconstruction.