Pulp plasty after toe-to-hand transplantation.

Pulp plasty is a simple procedure that is used to debulk the bulbous-appearing pulp of a transplanted digit after toe-to-hand transplantation. A retrospective review of the effect of pulp plasty on the appearance and function of the debulked digit was conducted of 82 digits on 51 patients. Pulp plasty was performed on average of 14 months after toe-to-hand transplantation; the average follow-up interval was 20 months. Subjective improvement in appearance and function was reported in 67.1 and 63.4 percent, respectively, of the debulked digits. Painful scarring was rare, and hypersensitivity was not reported. Sensation was not affected adversely by pulp plasty. The procedure was considered to be worthwhile in 87.8 percent of the cases. Pulp plasty is a simple and effective procedure after toe-to-hand transplantation that enhances the appearance and function of the transplanted digit. Patient satisfaction with the procedure is high.