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Rolling belt injuries are commonly seen in the summer when the tractors and water pumps work in agricultural fields. These machines' rolling belts may attract children and entrap their hands. The injuries frequently affect soft tissues and bone of volar side of their hands. Amputations may be seen.

In the present study, 45 patients with rolling belt injuries were retrospectively analysed. It was observed that 133 fingers of 42 patients and three hands (Zone III) of three patients were surgically treated. The treatment included primary closure of the lacerations, tendon/nerve repair, fixation of fractures, grafting, and local or cross-arm or groin flaps. Stump closure procedures were performed in 21 fingers with total amputations or non-viable tissues. The injuries in most of the cases were localised at Zones I and II. We performed revascularisation procedures in five fingers. Only one of them stayed alive (20%). Our results revealed that 13 cases were good, 21 were fair and 11 were poor to according to Gorsche and Wood criteria.

These injuries cause the burns and defects on digital arteries-veins as well as flexor tendons. Frequently, phalanx fractures and finger amputations may occur. Also, the skin defects are common. The treatment of rolling belt injuries is difficult, quite expensive, and the outcomes are not always satisfactory.

When tendons, bones or joints are exposed in infected digits, functional and cosmetic sequelae are frequent. We propose continuous negative pressure therapy with irrigation (NPI) for an infected digit with an open wound. Continuous NPI was evaluated in vitro and subsequently applied to a clinical case. Acceptable functional and cosmetic results were obtained without any problems when continuous NPI was performed in the clinical case. Continuous NPI may be a useful alternative for treatment of an infected digit with an open wound.