NINJA Trial Press Release

The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) is encouraging members to join the Nail bed INJury Analysis (NINJA) trial, which is the first plastic surgery study of its kind.

The Surgical Intervention Trials Unit (SITU) at the University of Oxford is co-ordinating this multi-centre study, funded by the National Institute for Health Research (NIHR). The team have published their early results in the British Journal of Surgery[1] and are currently recruiting patients across twenty sites in the UK. So far 147 participants and 16 open sites have been recruited.[2] We aim to recruit 416 patients in total. We would like to encourage plastic surgeons to help recruit more patients into this study.

Nail bed injuries are common. Typically, patients who experience this type of injury are toddlers whose fingertip is crushed by a closing door.

BAPRAS has recently highlighted that at least 50,000 toddlers suffer from crushed fingertip injuries every year, potentially causing lifelong damage. BAPRAS recommend that parents invest in doorstoppers to protect their children.

David Ward, President of BAPRAS: “We fully support the NINJA trial and encourage people to come forward to participate in this vital research. As BAPRAS’s recent awareness campaign highlighted in the national media, crushed-finger injuries are potentially serious. They can have a lifelong impact on the patient. BAPRAS is committed to ensuring the best possible treatment for patients in these cases. By supporting the NINJA research trial, BAPRAS is supporting surgeons to give the most appropriate and effective treatment.”

The trial will analyse whether the nail plate should be replaced or discarded after nail bed repair in children. Currently, the nail is removed and the nail bed is repaired using tiny dissolving stitches. The old nail plate is then either replaced under the proximal nail fold over the repaired nail bed, or discarded to allow a brand new nail to grow. Dressings are then applied. The NINJA trial will assess which is a better method.



About the NINJA Trial

The NINJA Trial (funded by the National Institute for Health Research) is a pragmatic multicentre study to assess whether the nail should be replaced or discarded after nail bed repair in children. The Surgical Intervention Trials Unit (SITU) at the University of Oxford, will co-ordinate the trial.  This is the first plastic surgery trial of its kind and will form part of a developing research portfolio for the plastic surgery community. More information on NINJA can be found here:


[2] Participating hospitals: Guy’s and St Thomas’ Hospitals, Oxford, Edinburgh, Peterborough City, Hull, Broomfield, Salisbury District, Stoke Mandeville, Cardiff – University Hospital of Wales, Queen Victoria Hospital, Leeds General Infirmary, James Cook University Hospital, Chelsea and Westminster, and The Lister Hospital in Stevenage, Manchester, Kings Mill Hospital in Mansfield.