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tomary referral to a surgeon for closure was never made. When the error
was caught a few days later, surgeon Cynthia Illingworth noticed that
the fingertip was regenerating! She
merely watched nature take its
course.
Illingworth began treating other children with such "neglect," and by
1974 she'd documented several hundred regrown fingertips, all in chil-
dren eleven years old or younger. Other clinical studies have since con-
firmed that young children's fingers cleanly sheared off beyond the
outermost crease of the outermost joint will invariably regrow perfectly
in about three months. This crease seems to be a sharp dividing line,
with no intermediate zone between perfect restoration and none at all.
Some pediatric surgeons, like Michael Bleicher of New York's Mount
Sinai Hospital, have become so confident in the infallibility of the pro-
cess that they'll finish amputating a fingertip that's just hanging by a bit
of flesh. A lost one will regenerate as good as new, whereas one that has
merely been mutilated will heal as a stump or with heavy scarring.
Fingertip regrowth is true multitissue regeneration. A blastema ap-
pears and redifferentiates into bone, cartilage, tendon, blood vessels,
skin, nail, cuticle, fingerprint, motor nerve, and the half-dozen spe-
cialized sensory-nerve endings in the skin. Like limb regeneration in
salamanders, this process only occurs if the wound isn't covered by a flap
of skin, as in the usual surgical treatment. Illingworth and her co-
worker Anthony Barker have since measured a negative current of injury
leaving the stump.
Sadly, natural replacement has been accepted only at a few hospitals.
Bleicher laments his colleagues' resistance to the evidence: "Mention it
to young residents just our of the training program, and they look at
you
as
though
you're
crazy.
Describe
it on grand rounds or at
other
institutions, and they
tell
you
it's hogwash."
Nearly all surgeons cling
instead to flashier and vastly more expensive yet less effective micro-
surgical techniques or simple stitches and stunted fingers.