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Dupuytren Foundation
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Post Surgical Issues

  • Post Surgical Issues
  • Early
    • Hematoma
    • Swelling 11291357
    • Infection
    • Flare – more common in women 3693825.
    • RSD 7% following open, 1564282, more likely in women 2229974 0% following needle aponeurotomy. Incidence may be less in severe contractures when surgery is performed in two stages 4007639.
    • Wound dehiscence
  • Later
    • Pseudoaneurysm
    • Inclusion cysts
    • Finger stiffness / loss of flexion is common 3944435, especially in women 3693825.
    • Recurrence
      • The majority of operated patients eventually have recurrent contractures 11252689, 10697321. Recurrence within the first few years after surgery has been reported in the range of 27% to 34% 1564282 1960492. Recurrence rates five years or more after surgery are higher, ranging from 40% to 74% 1564282 1481713, 1564282, 1284017,1284016, 3181828, 3233038 . Recurrence is much more likely when surgery has been required before the age of 50, when associated with Ledderhose or Peyronie’s disease, when the preoperative contracture is severe, or when accompanied by diabetes, alcoholism or epilepsy 3233038.
      • The small finger is the worst for recurrence 11496607, 1284016 , possibly because of the unique anatomy of tissues on the outer border of the small finger 2338307 .
      • Recurrence requiring repeat procedure after needle aponeurotomy is at least 24% 11496606, and has been reported as 23% following open fasciectomy 1564282.,
      • With diffuse skin involvement, dermofasciectomy is more successful fasciectomy in preventing recurrence10697321, 1284018, 3309018,and earlier surgery is recommended 1284017 .
      • Surgery for recurrent contracture due to Dupuytren’s disease may be successful only if it includes excision and skin flap rather than skin graft 10722821.
      • The relative risk of recurrence can be predicted by microscopic evaluation of tissue removed at surgery 2754197. Highly cellular lesions have higher rates of recurrence than do hypocellular lesions, a finding which may be demonstrated on MRI 8456670.
    • Keloid (rare) 10658118