Skin grafting prevents recurrence in Dupuytren's disease and extension correlates with fibrosis diathesis score

Torrekens, Marieke; Nuffel, Maarten Van; Couck, Isabel; Smet, Luc De; Degreef, Ilse

doi:10.1016/j.hansur.2021.03.008

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…Of course, this decrease becomes clinically mostly important in severe contractures since it can lead to skin shortage when the contractures are corrected through needle aponeurotomy, collagenase injections, or surgery. 40–43 The most common sites of skin rupture are over flexion creases and sometimes areas of the skin adherent to underlying cord. 40 The locations of our measurements were chosen with this in mind.…”

Section: Discussionmentioning

confidence: 99%

Palmar skin elasticity measured by the Cutometer MPA 580 is decreased in mild Dupuytren’s disease compared to healthy controls

et al. 2022

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Introduction Involvement of the palmar skin is often seen in patients with Dupuytren’s disease (DD) with severe finger contractures. However, skin elasticity may be already decreased earlier in the disease. The Cutometer MPA 580 could provide an objective skin measurement tool to assess this decrease in elasticity. Linking objective skin measurements to functional outcome measures could lead to better prediction of disease progression. We set up a study to investigate if the Cutometer was able to detect differences in skin elasticity between patients with mild Dupuytren’s disease and healthy controls. Methods A cross-sectional analytical study was performed. Three assessors measured skin elasticity (palmar hand) on two sites using the Cutometer on 30 patients with mild DD and 30 healthy controls. Student’s t-test was used to evaluate differences in skin elasticity and a linear model to evaluate interactions between the groups and sites. Results Significant differences in skin elasticity were found between DD patients and controls, as well as differences based on the location examined. Discussion Similar to other skin conditions, the Cutometer MPA 580 was able to demonstrate a significant lower elasticity in the palmar skin in DD patients compared to healthy controls. A decrease in skin elasticity in different locations of the hand correlated with areas that often pose problems in the treatment of more severe DD. The Cutometer could potentially be a tool to identify these areas earlier in the disease.

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Section: Discussionmentioning

confidence: 99%

Palmar skin elasticity measured by the Cutometer MPA 580 is decreased in mild Dupuytren’s disease compared to healthy controls

et al. 2022

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“…Для него свойственно наличие узелков на тыльной поверхности межфаланговых суставов (чаще проксимальных межфаланговых суставов -ПМФС), так называемых подушечек Garrod; положительный семейный анамнез (наличие данного заболевания у близких родственниковотец, мать и т.д. ); сочетание с болезнями Пейрони и Леддерхозе; склонность к рецидивированию и прогрессированию [22,23].…”

Section: эпидемиология и социальная значимостьunclassified

Skin Closure After Subtotal Aponeurectomy in Severe Dupuytren’s Contracture: Review

Idrisov¹,

Rodomanova

2022

Traumatology and Orthopedics of Russia

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Introduction. One of the significant problems of surgical treatment of Dupuytren's contracture is a deficiency of the skin as a result of suturing the wound after subtotal aponeurectomy. The size of the defect depends on the severity of the pathology. In the early stages of the disease, Z-plasty is widely used, but this method of plastic replacement does not completely cover the defect formed after surgical treatment of contracture of III-IV severity, especially when several fingers of the hand are lesioned. The purpose of the study. The purpose of the review is a comparative analysis of methods of plastic replacement of skin deficiency after subtotal aponeurectomy in patients with III-IV degree of severity of Dupuytren's contracture. Various tactics of treatment of this category of patients are described, including distraction elimination of contracture and further aponeurectomy, as well as various methods of plastic replacement of skin defects formed after resection of altered areas of palmar aponeurosis and elimination of contracture. Each of the proposed methods of surgical treatment has its advantages and disadvantages. Conclusions. An analysis of the relevant scientific literature has shown that the most common method of eliminating soft tissue deficiency after aponeurectomy is Z-plasty. However, due to an increase in the severity of the disease, its effectiveness decreases. To date, there is no consensus regarding the approach to the altered site of aponeurosis and there is no single method for eliminating tissue deficiency in the III-IV degree of the disease.

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“…Minimal invasive techniques such as needle fasciotomy and collagenase injections have a faster recovery, but incomplete correction and recurrence are markedly more frequent than open surgery ( 5 ). Fasciectomy can be augmented with skin grafting in cases of incomplete skin closure or to minimize recurrence ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Microfasciectomy in Dupuytren’s disease: microsurgery in the evolution toward safer and more efficient fasciectomy and hand surgery

2023

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In the long term, limited fasciectomy is currently the most reliable treatment for Dupuytren’s contracture. The risk for complications is significant, certainly in recurrent disease and in the presence of abundant scar tissue. Meticulous surgical technique is mandatory. Microsurgery increases magnification from four times (with surgical loupes) up to 40 times. Using the microscope in Dupuytren’s surgery, a technique named microfasciectomy is likely to increase both safety and efficiency by preventing instead of treating surgical complications. Increased experience with microsurgery will benefit Dupuytren’s treatment and hand surgery in general.

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Skin grafting prevents recurrence in Dupuytren's disease and extension correlates with fibrosis diathesis score

Cited by 7 publications

References 20 publications

Palmar skin elasticity measured by the Cutometer MPA 580 is decreased in mild Dupuytren’s disease compared to healthy controls

Palmar skin elasticity measured by the Cutometer MPA 580 is decreased in mild Dupuytren’s disease compared to healthy controls

Skin Closure After Subtotal Aponeurectomy in Severe Dupuytren’s Contracture: Review

Microfasciectomy in Dupuytren’s disease: microsurgery in the evolution toward safer and more efficient fasciectomy and hand surgery

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