Dermofasciectomy in the management of Dupuytren’s disease

Armstrong, J. R.; Hurren, Jeremy; Logan, A. M.

doi:10.1302/0301-620x.82b1.0820090

Cited by 62 publications

(31 citation statements)

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“…Clinically, full-thickness skin grafts (in which the dermis is included) have been shown to attenuate recurrence of DD in some studies [7,[74][75][76], implying that local environment of the DD cord left behind after resection may contain factors that promote disease recurrence. Our in vitro data suggest that PF fibroblasts, derived from the palmar fascia immediately adjacent to DD cord, are sensitive to periostin-induced proliferation.…”

Section: Discussionmentioning

confidence: 99%

Periostin differentially induces proliferation, contraction and apoptosis of primary Dupuytren's disease and adjacent palmar fascia cells

Vi¹,

Feng²,

Zhu³

et al. 2009

Experimental Cell Research

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Dupuytren's disease, (DD), is a fibroproliferative condition of the palmar fascia in the hand, typically resulting in permanent contracture of one or more fingers. This fibromatosis is similar to scarring and other fibroses in displaying excess collagen secretion and contractile myofibroblast differentiation. In this report we expand on previous data demonstrating that POSTN mRNA, which encodes the extra-cellular matrix protein periostin, is up-regulated in Dupuytren's disease cord tissue relative to phenotypically normal palmar fascia. We demonstrate that the protein product of POSTN, periostin, is abundant in Dupuytren's disease cord tissue while little or no periostin immunoreactivity is evident in patient-matched control tissues. The relevance of periostin up-regulation in DD was assessed in primary cultures of cells derived from diseased and phenotypically unaffected palmar fascia from the same patients. These cells were grown in type-1 collagen-enriched culture conditions with or without periostin addition to more closely replicate the in vivo environment. Periostinwas found to differentially regulate the apoptosis, proliferation, α smooth muscle actin expression and stressed Fibroblast Populated Collagen Lattice contraction of these cell types. We hypothesize that periostin, secreted by disease cord myofibroblasts into the extra-cellular matrix, promotes the transition of resident fibroblasts in the palmar fascia toward a myofibroblast phenotype, thereby promoting disease progression.

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Section: Discussionmentioning

confidence: 99%

Periostin differentially induces proliferation, contraction and apoptosis of primary Dupuytren's disease and adjacent palmar fascia cells

Vi¹,

Feng²,

Zhu³

et al. 2009

Experimental Cell Research

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“…Based on the observation that new cords did not seem to form at sites of prior skin grafting, the anticipated benefit of DF over LF is a lower recurrence rate. At a mean of 5.8 years following DF, recurrence was seen in 11.6 % of 103 patients and 8.4 % of 143 digits [2]. In a second study, 90 digits in 67 patients experienced 8 % recurrence by 24-100 months following DF [29].…”

Section: Dermofasciectomymentioning

confidence: 89%

Dupuytren's Disease: Current State of the Art

Henry

2013

Hand (New York, N,Y.)

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Background This review article critically examines the current literature for Dupuytren's disease. Methods Five procedures are considered: dermofasciectomy, limited fasciectomy, segmental aponeurectomy, needle aponeurotomy, and collagenase injection. Studies regarding the efficacy of these treatments focus primarily on the initial degree of correction, rate of recurrence, and complications. Results No one treatment has been declared superior and substantial controversy exists. Comparison between studies has been hampered by the absence of uniform definitions for clinical success and measurable disease progression. Traditional postoperative care includes formal therapy and night splinting, but recent studies have questioned the value of these adjuncts. Conclusion The extent of involvement at which the surgeon should intervene was previously well accepted by convention, but as the paradigm shifts towards less invasive procedures, treatment may be offered at an earlier stage. Future research should be structured to recognize the value-based decision making used by patients when selecting treatment.

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“…The currently applied therapies are symptomatic. A leading role in the treatment of DD is still played by surgical interventions, yet this way of treatment is by no means perfect as surgery is connected with a risk of complications -at a level of 20% [3,[29][30][31]. Both the intra-operative complications, such as damage of nerves or blood vessels and post-surgical complications (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…Both the intra-operative complications, such as damage of nerves or blood vessels and post-surgical complications (i.e. skin necrosis or haematoma) must be taken into consideration as well as remote complications, which might occur as a result of the lack of rehabilitation or its incorrect management [3,[30][31][32].…”

Section: Discussionmentioning

confidence: 99%