Plastic and Reconstructive Surgery, Global Open (Jul 2020)

Dupuytren’s Fasciectomy: Surgical Pearls in Planning and Dissection

  • Pennylouise Hever, MBChB, MRCS,
  • Oliver J. Smith, MBChB, BSc, MRCS,
  • Dariush Nikkhah, MBChB, FRCS(Plast)

DOI
https://doi.org/10.1097/GOX.0000000000002832
Journal volume & issue
Vol. 8, no. 7
p. e2832

Abstract

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Summary:. Fasciectomy remains the mainstay of surgical treatment for Dupuytren’s disease at many units worldwide, particularly in cases of recurrence after aponeurotomy or enzymatic fasciotomy. In some series, this has been reported as high as 48% in 3 years. The lead author has since abandoned the use of collagenase altogether. In this innovation article, we describe simple maneuvers to aid the planning and dissection of a Dupuytren’s fasciectomy. We describe techniques to enable efficient dissection of the cord and minimize problems when designing skin flaps. We also highlight technical points in revision cases.