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Dupuytren’s Skin Graft Controversy

Skin grafting is a time honored technique in the range of options to reduce the incidence of recurrence after fasciectomy for Dupuytren’s contracture. There are two general approaches. One is dermofasciectomy: remove a large area of affected skin and resurface the area with a similarly large skin graft. The other is to put in a smaller skin graft to break up the line of pull of the original cord, a firebreak skin graft. Several studies have documented the superiority of dermofasciectomy over fasciectomy, but what about firebreak grafts? Hot off the press, a controlled study reports that fasciectomy with firebreak skin graft doesn’t improve results compared to fasciectomy alone. Hmmmph!