Wound Complications in the Surgical Management of Dupuytren's Contracture: A Comparison of Operative Incisions

Abstract

A prospective study was carried out comparing the z-plasty, volar zig-zag and open-palm incisions in eighty-two patients undergoing partial selective fasciectomy for Dupuytren's disease. Flap necrosis, haematoma, and postoperative pain were greatest following the z-plasty and zig-zag incisions. While healing was somewhat delayed and a digital nerve was lacerated in the transverse open-palm group, the complication rate was lower overall and we now prefer this technique for partial selective fasciectomy for Dupuytren's disease.

The Complications of Dupuytren’s Contracture Surgery

“…Other studies have shown that open palm technique provides good results regarding hematoma and skin-edge necrosis, 11,12 which is confirmed in this series. Skin slough or wound-edge necrosis (2.4%) was low compared with published data (Table 4).…”

Effect of Severity of Dupuytren contracture on disability

“…There is a direct relation between the extent of the procedure and postoperative morbidity [7Á9]. Complications are numerous, up to 10% of wound problems [10]. The complications often result in compromised flexion [11], which interferes directly with grasping.…”

Minimally Invasive Technique for Release of Dupuytren's Contracture: Segmental Fasciectomy through Multiple Transverse Incisions

“…Digital flexion was not found to be problematic, except in one patient whose proximal interphalangeal flexion was 10°shy of maximum in two affected Nine of 14 patients required narcotic pain medications following surgery. Seven patients (50%) required pain medications for 1 day only and had mild pain, according to a Dupuytren's contracture postoperative pain scale proposed by Gelberman et al [7]. Two patients required pain medications for 7-10 days following surgery and had severe pain.…”