The Use of Acellular Dermal Matrix in Dupuytren Disease
Recurrence following surgical treatment of Dupuytren disease remains a common problem. We hypothesize that the use of acellular dermal matrix is associated with decreased recurrence rates in Dupuytren disease.
We performed a retrospective cohort study of 43 patients undergoing open fasciectomy for Dupuytren disease from year 2005 to 2012 performed by a single surgeon at our academic institution. Standard fasciectomies of the affected palmar and digital fascia were performed via Bruner incision on all patients. Patients in one group had a sheet of acellular dermal matrix (Alloderm, LifeCell, Bridgewater, NJ) sutured into the surgical bed prior to closure, whereas patients in the control group were not closed with acellular dermal matrix. Patients were then evaluated at follow-up for disease recurrence, defined as presence of Dupuytren tissue in an area previously operated on, with a contracture greater than that recorded following the surgical fasciectomy.
Among our cohort of 43 patients, 23 (53.5 %) were treated with acellular dermal matrix while 20 (46.5 %) were not. The median age of our cohort was 66.5 years (range 54–91 years). The median follow-up was 1.8 years. During this follow-up period, recurrence of contracture was observed in 1 of 23 patients in the group of patients with acellular dermal matrix placed, compared to 5 of 20 in the control group (P = 0.045). No differences in the incidence of minor wound complications were observed.
We observed lower recurrence rates in the cohort of patients who were treated with placement of acellular dermal matrix into the wound bed following open fasciectomy for Dupuytren disease. Our novel technique has implications for future surgical treatment strategies to reduce recurrence rates in Dupuytren disease.
KeywordsAcellular dermal matrix Contracture Dupuytren disease Hand surgery Recurrence Therapeutic intervention
Conflict of Interest Declaration
The authors have no disclosures.