A Simple Dressing Technique Following Dermofasciectomy and Full Thickness Skin Grafting of the Fingers in the Treatment of Severe Dupuytren’s Contracture

Tanagho, Andy; Beaumont, Jan; Thomas, Roshin

doi:10.1007/s12593-015-0208-0

Cited by 5 publications

(4 citation statements)

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“…In other words, only closing the skin is not sufficient. Various techniques have been attempted previously, such as Burner volar zig-zag, [ 17 , 18 ] open palm technique, [ 19 , 20 ] the “Jacobsen flap” technique, [ 21 ] multiple ZP, [ 22 ] multiple V-Y plasty, [ 18 ] YV and ZP, [ 23 ] skin grafting, [ 24 , 25 ] artery perforator flap, [ 1 , 2 ] hypothenar flap, [ 3 ] ulnar parametacarpal flap, [ 4 ] and DLF, [ 5 ] among others. In our department, we initially performed YV and ZP, but we later used a DLF, which is the simplest and least invasive of these techniques for closing the wound, in combination with YV and ZP.…”

Section: Discussionmentioning

confidence: 99%

Skin extension with a digito-lateral flap and early active finger extension training for Dupuytren contracture: A retrospective study

et al. 2022

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In the surgical management of Dupuytren contracture (DC), Y-V plasty (YV) and Z-plasty (ZP) are techniques often used for skin extension. However, achieving sufficient skin extension with these procedures alone is often difficult. Therefore, we addressed this issue with an adjunctive digito-lateral flap (DLF) and report the clinical results of the surgery using a DLF in addition to YV and ZP. Fifteen patients with DC (15 affected fingers) underwent partial fasciectomy using a DLF in addition to YV or ZP, and early active finger extension training was performed immediately after the operation. The flap survival rate, preoperative and postoperative extension angle, Tonkin contracture improvement (TCI) rate, and Tubiana staging grades were evaluated. The contracture sites were at 4 proximal interphalangeal (PIP) and 3 metacarpophalangeal (MP) joints of the little finger and 4 PIP and MP joints each of the ring and little fingers. All the flaps survived, and the extension angle improved at the final observation from a preoperative mean of −45° to −3° and −55° to 5° for the PIP and MP joints, respectively. One patient with PIP joint contracture treated in the early stage of the study experienced a persistent 5° limitation of extension, even though the TCI rate was satisfactory (91.9%) and the outcome was "good." Full extension of the joints was achieved in 15 patients, in whom the TCI rate was 100% and the outcome was "very good." This technique was able to solve 3 important steps to achieve full extension: intraoperatively, wound closure, and rehabilitation. We attained and maintained long-term full extension intraoperatively and immediately after surgery and obtained very good treatment results, as shown in this study. In conclusion, highly favorable clinical outcomes were achieved through the combination of a DLF with YV and ZP. Skin extension with a DLF is a useful surgical technique for DC.

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Section: Discussionmentioning

confidence: 99%

Skin extension with a digito-lateral flap and early active finger extension training for Dupuytren contracture: A retrospective study

et al. 2022

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“…Recurrence rates are low, being similar to those of extensive fasciectomy. Among the noteworthy downsides: prolonged recovery, skin graft failure, donor site scarring, a higher complication rate, and poor skin color/texture match [30,31]. [43].…”

Section: Dermofasciectomymentioning

confidence: 99%

Challenges and innovations in the surgical treatment of advanced Dupuytren’s disease by percutaneous needle fasciotomy: indications, limitations, and medico-legal implications

Basile,

Amadei,

Prevot

et al. 2024

Preprint

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Background Dupuytren's disease, a chronic thickening and retraction of the palmar aponeurosis of the hands, may result in permanent and progressive flexion of one or more fingers. Percutaneous needle fasciotomy is a simple method that uses a hypodermic needle usually performed under local anaesthesia. The study aim was to report the postoperative results and complications using a percutaneous approach to treat Dupuytren's contracture in a consecutive series of patients with advanced Dupuytren’s disease, also considering the relevant medico-legal implications. Methods Retrospective multicentre study of all patients with Tubiana stage 3–4 Dupuytren's contracture treated with percutaneous needle aponeurotomy from 2012 to 2022. Patient demographics, disease severity, treatment-related complications, and the incidence of recurrence were identified. An overview of therapeutic treatment options has accounted for 52 relevant sources spanning the 2007–2023 time period. Results Overall, 41.7% (N = 200 ) of patients were females, the mean age was 72 years (60–89), the right hand was treated in 54.2% (N = 260 ) of patients. The little finger was involved in 50% of the patients. The 12 months mean PED was 9°, the mean quickDASH was 8, the mean URAM 6. Minor complications were reported in 18.7% (N = 90) of patients, typically skin lacerations (83.3%) with no clinical sequelae, and no major complications were reported. Recurrence occurred in 30% (N = 144) of patients. Conclusions Percutaneous needle fasciotomy is safe and reliable even in patients with advanced Dupuytren's disease, resulting in predictably acceptable outcome with low risk of complications.

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“…The procedure relies on the removal of the diseased fascia along with overlying skin. A full thickness skin graft is applied after the wound is resurfaced [32]. focused ESWT [45].…”

Section: Dermofasciectomymentioning

confidence: 99%

Challenges and innovations in the surgical treatment of advanced Dupuytren disease by percutaneous needle fasciotomy: indications, limitations, and medico-legal implications

Basile,

Amadei,

Prevot

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Dupuytren disease, a chronic thickening and retraction of the palmar aponeurosis of the hands, may result in permanent and progressive flexion of one or more fingers. Percutaneous needle fasciotomy is a simple method that uses a hypodermic needle usually performed under local anaesthesia. The study aim was to report the postoperative results and complications using a percutaneous approach to treat Dupuytren contracture in a consecutive series of patients with advanced Dupuytren disease, also considering the relevant medico-legal implications. Methods Retrospective multicentre study of all patients with Tubiana stage 3–4 Dupuytren contracture treated with percutaneous needle aponeurotomy from 2012 to 2022. Patient demographics, disease severity, treatment-related complications, and the incidence of recurrence were identified. An overview of therapeutic treatment options has accounted for 52 relevant sources spanning the 2007–2023 time period. Results Overall, 41.7% (N = 200 ) of patients were females, the mean age was 72 years (60–89), the right hand was treated in 54.2% (N = 260 ) of patients. The little finger was involved in 50% of the patients. The 12 months mean PED was 9°, the mean quickDASH was 8, the mean URAM 6. Minor complications were reported in 18.7% (N = 90) of patients, typically skin lacerations (83.3%) with no clinical sequelae, and no major complications were reported. Recurrence occurred in 30% (N = 144) of patients. Conclusions Percutaneous needle fasciotomy is safe and reliable even in patients with advanced Dupuytren disease, resulting in predictably acceptable outcome with low risk of complications.

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A Simple Dressing Technique Following Dermofasciectomy and Full Thickness Skin Grafting of the Fingers in the Treatment of Severe Dupuytren’s Contracture

Cited by 5 publications

References 0 publications

Skin extension with a digito-lateral flap and early active finger extension training for Dupuytren contracture: A retrospective study

Skin extension with a digito-lateral flap and early active finger extension training for Dupuytren contracture: A retrospective study

Challenges and innovations in the surgical treatment of advanced Dupuytren’s disease by percutaneous needle fasciotomy: indications, limitations, and medico-legal implications

Challenges and innovations in the surgical treatment of advanced Dupuytren disease by percutaneous needle fasciotomy: indications, limitations, and medico-legal implications

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