Methods: Between March 2006 and March 2017, 35 patients underwent great toe pulp grafts for reconstruction of fingertip amputation. A fish-mouth incision was applied to the injured fingertip to create a wedge-shaped defect. Composite tissue from the fibular aspect of the great toe was harvested in a “watermelon slice cutting” manner to obtain a wedge-shaped volume of tissue. The wedge was then snuggly fit into the recipient, amplifying contact surface. Evaluation included total operation length, graft survival and donor site morbidity.
Results: A total of 35 patients received 37 great toe pulp grafts. 37 fingertips underwent immediate or secondary reconstruction of fingertip. Total survival was found in 36 fingertips (97.3%). Partial necrosis was observed in one fingertip (2.7%).
Conclusion: This simple wedge modification of the great toe pulp graft enhances ease of donor site closure, graft inset, and most importantly graft survival.