Surgical outcome of Dupuytren’s disease—no higher self-reported recurrence after segmental fasciectomy

Surgical outcome of Dupuytren’s disease—no higher self-reported recurrence after segmental... A single-center survey on the patients’ perception of recurrence after Dupuytren’s surgery was conducted. To evaluate the impact of surgical techniques on self-reported recurrence rates, a retrospective analysis of 216 surgically treated patients with a minimum 2-year follow-up was conducted using a postal questionnaire. Reported recurrence rates were somewhat lower in segmental fasciectomy (43%), which was performed in 39% of the patients compared to an overall reported recurrence rate of 54% in all surgical procedures. In total fasciectomy with skin resection and grafting, patients reported a surprisingly high recurrence rate of 63%. By taking the prognostic value of diathesis into account, the difference in recurrence rates between surgical techniques was not statistically significant. Nevertheless, no higher recurrence risk in segmental fasciectomy was noticed and total fasciectomy with or without skin resection did not appear to guarantee indefinite results. At this point, surgical treatment in Dupuytren’s disease is confined to correcting contractures, without curing the patients. Therefore, unless segmental fasciectomy is not feasible due to the severity of the contractures, we suggest to always consider minimal invasive surgery as a surgical option in the treatment of Dupuytren’s disease. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Surgical outcome of Dupuytren’s disease—no higher self-reported recurrence after segmental fasciectomy

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Publisher
Springer-Verlag
Copyright
Copyright © 2009 by Springer-Verlag
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-009-0339-2
Publisher site
See Article on Publisher Site

Abstract

A single-center survey on the patients’ perception of recurrence after Dupuytren’s surgery was conducted. To evaluate the impact of surgical techniques on self-reported recurrence rates, a retrospective analysis of 216 surgically treated patients with a minimum 2-year follow-up was conducted using a postal questionnaire. Reported recurrence rates were somewhat lower in segmental fasciectomy (43%), which was performed in 39% of the patients compared to an overall reported recurrence rate of 54% in all surgical procedures. In total fasciectomy with skin resection and grafting, patients reported a surprisingly high recurrence rate of 63%. By taking the prognostic value of diathesis into account, the difference in recurrence rates between surgical techniques was not statistically significant. Nevertheless, no higher recurrence risk in segmental fasciectomy was noticed and total fasciectomy with or without skin resection did not appear to guarantee indefinite results. At this point, surgical treatment in Dupuytren’s disease is confined to correcting contractures, without curing the patients. Therefore, unless segmental fasciectomy is not feasible due to the severity of the contractures, we suggest to always consider minimal invasive surgery as a surgical option in the treatment of Dupuytren’s disease.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Aug 1, 2009

References

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