STATS ARTICLES 2008

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Silliest science story of the year
Trevor Butterworth, December 2008
Giving the finger to Pixie Dust

wounded fingertipIn April, the BBC claimed a “worldwide exclusive” on the story of Lee Spievack, a hobby store salesman who had an unfortunate accident with a model plane. "I put my finger in," Mr Spievak told the BBC, pointing towards the propeller of a model aeroplane, "and that's when I sliced my finger off. It took the end right off, down to the bone, about half an inch. We don't know where the piece went." Thanks to the application of what Mr. Spievak called “pixie dust,” a powder extract of pig’s bladder labeled “extracellular matrix” and sent to him by his surgeon brother, he grew his finger back.

The story had already been reported in the U.S. by CBS in February, when the Evening News with Katie Couric announced that the “holy grail of healing” had been found: “You might become a believer in the power of magic dust,” said reporter Wyatt Andrews, “when you see how a special powder re-grew the tip of Lee Spievack's finger,” (In fact, the miracle had been briefly reported by the AP in 2007)

But when Dr. Ben Goldacre, the Guardian newspaper’s “bad science” columnist and a full-time medical doctor looked at a photo of Spievack’s wound prior to treatment, he noted a slight problem: “there is no missing finger.” Spievack had simply lost some flesh from the tip, which meant the magical re-growth had been accomplished by nature.

 

“This is quite normal for fingertip injuries,” Dr. Michael Hausman M.D., Lippman Professor of Orthopedic Surgery at Mt. Sinai Medical Center in New York told STATS. “The ability of our fingertip pulp to regenerate is the last, best reminder of our distant relations to the starfish. The ‘official’ treatment recommendations for fingertip injuries is to do nothing but a clean, dry dressing for wounds [less than one centimeter squared], as they will ‘regenerate’ or heal without difficulty. Even larger wounds will heal well, although there will be a slight deformity or flattening.”

The BBC at least faced up to the fact that it had inhaled too much journalistic “pixie dust.” The news organization reported several days after the initial broadcast that finger tips can actually grow back all by themselves, and that medical experts were rather skeptical of regenerative powders.

As Professor Stephen Minger, an expert in stem cell and regenerative medicine at Kings College London, told the BBC: “I don't see how they could re-grow a fingertip by sprinkling on extracellular matrix.”

CBS reported that “the matrix's unusual power to regenerate tissue” was helping to “launch a new field: regenerative medicine.” But Dr. Hausman tells STATS that “At most, such products can provide a clean, moist, protective environment that optimizes the conditions for the body's normal healing mechanisms.”

Even more embarrassing, the expert in “regeneration” cited in the news reports turned out to be chief scientist for Acell, the company Spievack’s brother owns – the one which makes the “pixie dust.”

Neither the Associated Press nor CBS corrected their stories.

 

Time helps a healing hand
Thankfully, many injuries to the hand don’t require magic dust or miracles to heal – just time and a sterile environment as these two photos provided by Mt. Sinai’s Dr. Hausman show.

“There is much unnecessary surgery done for these common injuries that are really best treated with a dressing,” says Dr. Hausman. “The normal process of wound healing involves contraction around the wound edges, thus making the area of injury smaller.

hand wound

The skin of the palm (called glaborous skin) does have exceptionally good healing propertiess, for reasons no one understands. There probably is a trip to Stockholm in the cards for the person who discovers the answer to that. During certain types of surgery, we routinely leave the skin open and these gaping wounds heal to a virtually imperceptable line.”

hand healed

“If the loss involves the bone, healing will be more problematic, as it will if the sterile matrix (pink stuff under the fingernail) is lost. Incidentally, temporarily increased nail growth is normal, probably due to increased blood flow.”

What to do if you finger tip gets Spievacked
“See a hand specialist,” says Dr. Hausman, “and put a clean bandage on the area. Creams, such as Neosporin, are not helpful and may actually macerate the skin because many are petroleum based. Similarly, vitamin E is probably not of any benefit. If, after the body has healed, there is a deficit, then there are a variety of reconstructive options, ranging from replacing the skin to replacing an entire digit by transplanting a toe using microvascular surgical techniques.

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