Skin Graft Review in Dermofasciectomy for Dupuytren’s Contracture within 48 Hours: Challenging Historical Practice

Author:

Ansari Saif Akhter1,Kennedy James Andrew2,Younis Fizan1

Affiliation:

1. Department of Hand Surgery, East Lancashire Hospitals National Health Service Trust, Lancashire, United Kingdom

2. Health Education North West Trauma and Orthopaedics, Health Education North West, Lancashire, United Kingdom

Abstract

Abstract Introduction Early review of skin graft following dermofasciectomy with skin grafting for Dupuytren’s disease is not standard practice because of the potentially adverse effects on inosculation and neovascularization process of the skin grafting. The purpose of this retrospective case series was to observe whether early review of grafts postoperatively at 48 hours adversely affects graft survival and surgical outcomes. Materials and Methods Forty-nine primary and revision procedures were retrospectively analyzed for treatment outcomes, postoperative complications, functional hand scoring, and satisfaction rates postoperatively. Results Thirty-eight patients were treated successfully with no postoperative contracture. There were three treatment failures and two graft failures, with two amputations within these failures. Paired pre- and postoperative Unité Rhumatologique des Affections de la Main scoring demonstrated significant improvement in hand function for primary procedures, with a mean satisfaction score of 7.7 out of 10. Conclusion We have shown early graft review following dermofasciectomy and full-thickness skin grafting to be safe, allowing early mobilization and splinting, with our postoperative failure and complication rate being within published literature.

Publisher

Georg Thieme Verlag KG

Subject

Surgery

Reference24 articles.

1. Dupuytren disease: an evolving understanding of an age-old disease;E M Black;J Am Acad Orthop Surg,2011

2. Digital Wolfe grafts in recurrent Dupuytren’s contracture;J T Hueston;Plast Reconstr Surg Transplant Bull,1962

3. [Importance of skin graft in preventing recurrence of Dupuytren’s contracture];F Villani;Chir Main,2009

4. The open palm technique in Dupuytren’s contracture;C R McCash;Br J Plast Surg,1964

5. The McCash technique for Dupuytren’s disease: our experience;A B Zoubos;Hand Surg,2014

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