Is Recurrence of Dupuytren Disease Avoided in Full-Thickness Grafting?

Abstract

In Dupuytren contractures, minimal invasive treatment is considered whenever feasible. However, in recurrent disease, surgery can be challenging and complications as damage to nerves or vessels are an immanent risk. Therefore, whenever surgery is considered, recurrence should be avoided if possible. Minimal invasive surgery is not clearly prone to recurrence, and more invasive procedures do not guarantee an indefinite result. However, skin involvement may play a role in recurrent contractures, and therefore, skin resection and full-thickness grafting may prevent recurrence. In this chapter, the role of the skin and recurrence after full-thickness grafting is explored. The hypothesis that recurrence after fasciectomy and full-thickness skin grafting for correction of Dupuytren contractures is nonexistent was investigated in a long-term follow-up study at our hand unit and compared with earlier results. Although some controversy remains in primary treatment, evidence is increasing to certainly consider the use of the full-thickness skin grafting for Dupuytren disease control in recurrent contractures, as to avoid severe recurrent disease and the need for complex revision surgery.