# Analysis of Digital Ischemic Necrosis from Constrictive Finger Dressings: A Case Series

## TL;DR

This paper reports nine cases of finger tissue death caused by tight dressings, showing that early recognition and proper care can prevent severe injuries.

## Contribution

The study provides a case series highlighting the distinction between iatrogenic and caregiver-induced ischemic necrosis and their outcomes.

## Key findings

- Seven cases of ischemic necrosis were iatrogenic, caused by medical dressings.
- Caregiver-induced cases resulted in more severe injuries and often required reconstructive surgery.
- Delayed recognition was associated with worse outcomes in caregiver-induced cases.

## Abstract

Digital ischemic necrosis can result from circumferential compression by medical dressings or domestic materials, particularly in pediatric patients. We present nine cases of ischemic necrosis caused by constrictive finger dressings between 2014 and 2024. Seven cases were iatrogenic, related to medical dressings, and two were caregiver-induced. Caregiver-induced cases tended to show more severe injuries, often necessitating reconstructive procedures such as free flaps, and these patients generally presented later than those with iatrogenic injuries. The contrast in timing and severity between the two groups suggests that delayed recognition may contribute to less favorable outcomes. These cases highlight the preventable nature of this condition and emphasize the importance of early recognition, proper wound monitoring, and caregiver education to minimize tissue loss and reduce the need for complex reconstructive surgery.