Article Text

Download PDFPDF
Case report
Acellular dermal matrix reconstruction of a nail bed avulsion in a 13-year-old child
  1. Ailbhe L Kiely1,2,
  2. Lilli RL Cooper2 and
  3. Aina Greig2
  1. 1Department of Plastic and Reconstructive Surgery, Queen Elizabeth Hospital, Birmingham, UK
  2. 2Department of Plastic and Reconstructive Surgery, Guy's and Saint Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to Ailbhe L Kiely; ailbhe.kiely{at}


Nail bed avulsion injuries often require reconstruction, particularly in cases where the avulsed fragment is lost. We describe a simple way to reconstruct a large nail bed defect, with no donor site. A 13-year-old boy with a hypoplastic left heart and autism accidentally sustained a left little distal phalanx injury with an avulsion of 60% of the nail bed, exposing the distal phalanx. This boy had a history of poor compliance, qualifying the need to find a technique that would minimise operative time and dressing changes. As such, it was elected to use an acellular dermal matrix (ADM) (Matriderm) as a one-step reconstruction. Signs of vascularisation of the ADM were noted at 2 weeks, and 3-month follow-up demonstrated integration, with normal nail growth. We found that Matriderm was able to support the regeneration of a full thickness wound in a simple one-step procedure.

  • orthopaedic and trauma surgery
  • plastic and reconstructive surgery
  • paediatric surgery
  • trauma

Statistics from


  • Contributors AK: assisted with operation and wrote manuscript. LRLC: performed operation, contributed to manuscript and organised follow up. AG: recruited patient, supervised operation, suggested the intervention, followed up patient and approved manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.