scholarly journals Dupuytren’s disease: using keystone techniques to improve vascular dynamics

2019 ◽  
Vol 2 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Felix Behan
Keyword(s):  
Vascular Complications ◽  
Dupuytren’S Disease ◽  
Postoperative Phase ◽  
Skin Grafts ◽  
Full Thickness ◽  
Hand Therapy ◽  
Dupuytren's Disease ◽  
Aesthetic Appearance ◽  
Appearance Matching ◽  
Surgical Release

Background: Palmar defects arising from surgical correction for Dupuytren’s disease can be surgically corrected using skin grafts. This article describes the applications of keystone principles as an alternative to John Hueston’s firebreak graft, popularised in the mid-1980s. Method: In 2003, I introduced the principle of a fenestrated, full-thickness graft to optimise graft-take and expedite healing, offering an alternative for the management of palmar defects created by surgical release. Results: The combination of reliable hypervascularity with a pain-free postoperative phase, characteristic of KPIF, ensures an easy recovery with early commencement of hand therapy. With minimal vascular complications (apart from clinical cases where diabetes and smoking are factors) the overall surgical outcome gives an aesthetic appearance matching surrounding tissues. Conclusion: Island flaps based on the keystone principle improve vascularity resulting in minimal complications with healing. Recurrence of Dupuytren’s disease following this technique has not been observed to date. 

Skin Replacement in Dupuytren’s Disease

1997 ◽  
Vol 22 (2) ◽  
pp. 193-197 ◽  
Author(s):  
P. N. HALL ◽  
A. FITZGERALD ◽  
G. D. STERNE ◽  
A. M. LOGAN
Keyword(s):  
Disease Control ◽  
Recurrence Rate ◽  
Dupuytren’S Disease ◽  
Skin Grafts ◽  
Skin Involvement ◽  
Joint Movement ◽  
Dupuytren's Disease ◽  
Primary Procedure ◽  
Skin Replacement

We have reviewed 90 rays in 67 patients who had undergone radical digital dermofasciectomy. Follow-up was from 24 to 100 months. Problems with skin grafts, moving two-point discrimination and active range of joint movement were noted. The recurrence rate in this series was 8%, a very much better figure for disease control than has been reported for standard approaches for Dupuytren’s disease. Radical digital dermofasciectomy is strongly recommended for all cases of recurrent Dupuytren’s disease requiring reoperation and as a primary procedure when there is significant skin involvement.

A new surgical approach to Dupuytren’s disease

2011 ◽  
Vol 36 (6) ◽  
pp. 485-489 ◽  
Author(s):  
I. Edmunds ◽  
C. Chien
Keyword(s):  
Surgical Approach ◽  
Dupuytren’S Disease ◽  
Axial Line ◽  
Skin Grafts ◽  
Dupuytren's Disease ◽  
Significant Complication ◽  
Advancement Flaps ◽  
Traditional Approaches

We present a new surgical approach for Dupuytren’s disease which overcomes some of the problems seen with traditional approaches. The approach is simple but allows full exposure and accommodates all options for closure. It comprises transverse incisions at the skin creases of the digit joined by oblique incisions at 45°. The transverse incisions can be extended to the mid-axial line for improved exposure and skin release and to lateralize the apices of the scar. After excision of the disease and correction of the contracture the wound can be assessed and closed primarily, with advancement flaps or skin grafts, or left partially open. This study includes surgery on 105 rays in 75 patients with excellent results in 80 rays, good results in 20 rays, fair results in four rays and a poor result in one ray. There was only one significant complication.

Dupuytren’s Disease in African-Americans

1998 ◽  
Vol 23 (3) ◽  
pp. 306-307 ◽  
Author(s):  
M. H. GONZALEZ ◽  
J. SOBESKI ◽  
S. GRINDEL ◽  
B. CHUNPRAPAPH ◽  
N. WEINZWEIG
Keyword(s):  
African American ◽  
African Americans ◽  
Dupuytren’S Disease ◽  
Dupuytren’S Contracture ◽  
Dupuytren's Disease ◽  
Dupuytren's Contracture ◽  
Surgical Release

Seventeen African-American patients were operated on for Dupuytren’s contracture over a 14-year period. Six-month minimum follow-up was available for 16 patients. The initial deformity, and results of surgical release of Dupuytren’s contracture in this population was similar to that described in North Europeans.

scholarly journals Reconstruction of full thickness wounds using glyaderm in a single-staged procedure

2021 ◽  
Author(s):  
Melissa de Henau ◽  
Anne Sophie Kruit ◽  
Dietmar J. O. Ulrich
Keyword(s):  
Donor Site ◽  
Case Series ◽  
Skin Surface ◽  
Donor Site Morbidity ◽  
Dermal Substitute ◽  
Skin Grafts ◽  
Full Thickness ◽  
Graft Take ◽  
Aesthetic Appearance ◽  
Thickness Skin

Abstract Introduction In large full-thickness skin defects, donor site morbidity limits the available thickness and surface of skin autografts and therefore only split-thickness skin grafts are possible for reconstruction. Dermal equivalents can be added to these split-thickness grafts to acquire an anatomically better skin reconstruction. Glyaderm is a human derived, acellular dermis and up until now has only been used in a two-staged procedure. This report describes results of a case series using Glyaderm and split-thickness skin grafts in a single-staged procedure. Methods Glyaderm was introduced in 2017 in Radboudumc (Nijmegen, The Netherlands). Glyaderm and autologous split-skin grafts were simultaneously applied to the wounds. In cases with large wound surfaces or wounds covering highly mobile areas, negative pressure wound therapy was additionally applied. The first ten cases were followed with regular intervals post-operatively, assessing graft take, scar appearance, post-operative wound problems and re-interventions. Results Patients were aged 3 weeks to 76 years-old. Treated skin surface varied from 1–16% total body surface. Wounds resulted from trauma (n = 4), burns (n = 4) or soft tissue infections (n = 2). Follow-up varied from 4 months to 1.5 years. No complications occurred after surgery. Average take rate was 98%. Two patients had a later re-intervention to further improve the aesthetic appearance of the scarred area. Conclusion Our first results with the application of Glyaderm in a single-staged procedure provided good healing, graft take and scar appearance. Glyaderm was found a suitable dermal substitute in the treatment of full thickness wounds.

scholarly journals Prevalence and Risk of Dupuytrèn Disease in Patients with Diabetes Versus Non-Diabetic Patients

2012 ◽  
Vol 19 (4) ◽  
pp. 373-380
Author(s):  
Denisa Kovacs ◽  
Luiza Demian ◽  
Aurel Babeş
Keyword(s):  
Type 2 Diabetes ◽  
Vascular Complications ◽  
Dupuytren’S Disease ◽  
Diabetic Patients ◽  
Dupuytren's Disease ◽  
Clinical Center ◽  
Patients With Diabetes ◽  
Dupuytren Disease

AbstractObjectives: The aim of the study was to calculate the prevalence rates and risk ofappearance of Dupuytrèn disease in diabetic patients with both type-1 (T1DM) andtype-2 diabetes (T2DM). Material and Method: 384 patients were analysed, ofwhich 47 had T1DM, 140 had T2DM and 197 were non-diabetic controls. Diabeticpatients were followed at the Clinical Center for Diabetes, Nutrition and MetabolicDisease of the Emergency Clinical County Hospital and Department of Dermatologyin Oradea, all of them having a diabetes duration of at least 5 years. Results and Conclusions: The risk of Dupuytrèn’s disease is over 4.5 times greater in patientswith type-2 diabetes. The risk of Dupuytrèn’s disease is 3-6 times greater in patientswith micro-vascular complications.

scholarly journals Postoperative hand therapy in Dupuytren's disease

2007 ◽  
Vol 29 (22) ◽  
pp. 1736-1741 ◽  
Author(s):  
Hester Herweijer ◽  
Pieter U. Dijkstra ◽  
Jean-Philippe A. Nicolai ◽  
Corry K. van der Sluis
Keyword(s):  
Dupuytren’S Disease ◽  
Hand Therapy ◽  
Dupuytren's Disease
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