ABSTRACT
Introduction The aim of this study was to explore the outcomes of composite grafts in fingertip amputations in children as well as the contributing factors that may affect outcomes. Methods Literature search was conducted across six databases in March 2022 to select studies on the use of composite grafts on fingertip amputations in the pediatric population. Results Twelve articles with 735 composite grafts were identified for review. Most fingertip injuries occurred in the less than 5-year age group and were due to crush type injuries. In studies that reported "complete" graft take as a separate outcome measure, 17.3% of fingertips with this result were observed. In the studies that reported "complete" and "partial" graft take together as an outcome measure, 81.6% of fingertips achieved this outcome. A lower proportion of failed graft take was observed in more distal fingertip amputations. Infection (3.8%) and nail abnormalities (3.4%) were the most common complications following composite grafting. Conclusion Composite grafting can be considered as a useful method of treatment in this population. Clinicians should be aware of the potential complications following this method of treatment such as infection and nail abnormalities. More proximal fingertip amputations may warrant other surgical interventions (beyond Level II on the modified Ishikawa/Ishikawa classification). Significant heterogeneity was observed within the studies, mainly due to lack of standardization in assessment and reporting of outcomes.
ABSTRACT
OBJECTIVES: To evaluate the effects of the COVID-19 lockdown on the self-reported perception of physical and mental health, in a cohort of teenagers. To assess the extent to which these effects are perceived as detrimental.Non-directional Hypothesis - the perception of physical and mental health will change over the duration of the eight weeks, due to the effects of the lockdown, as a result of COVID-19. DESIGN: This was a prospective longitudinal study evaluating the effects of the COVID-19 lockdown in the UK over the eight week period, against the political timeline during which the study was conducted (April 08, 2020-June 04, 2020). SETTING: Participants were all in secondary education, ranging from years 10-13 (ages 15-18). PARTICIPANTS: 55 volunteers have taken part in the study, the group of participants was mixed-sex and of different ethnic groups. Participants were chosen via an opportunity sampling method. All participants stem from a middle to high socioeconomic background. The target demographic of the study was teenagers in secondary education, so participants have been selected from a volunteer sample that is representative of this population. MAIN OUTCOME MEASURES: Physical health and Mental health. RESULTS: Data obtained was synchronised with the political timeline over the eight week period, in order to provide specific interpretations for the findings of the study.Measures of physical health: Sleep with a median length of 8 âh in comparison to seven before lockdown (SD between 1.236 and 1.835); 70.00% of participants experienced a decline in their physical health; Productivity amongst participants slightly decreased (76.70%-62.90%). The measures of mental health: Length of screen time, with a median length of 6 âh in comparison to four before lockdown (SD between 1.48 and 3.3), however, it remained stagnant over the study period and participants did not experience a further increase; The number of hours spent on social media also increased, with an increasing number of participants spending over 4 âh on social media; Conflicts increased in their family environment (from 25.60% to 37.10% of participants reporting more conflicts). During virtual school, conflict was at its lowest point (18.40%) and harmony in the family environment was at its highest peak (65.80%). 51.00% of participants relayed a decline in their mental health. A statistically significant correlation was found between exercise and creativity, both of which decreased over the study period (rs â= â0.42 is bigger than the critical value â= â0.22 when p â= â0.05). CONCLUSIONS: Despite certain positive effects, the overall impact of lockdown during the COVID-19 pandemic has been negative, regarding both physical and mental health, for this cohort of young people.
