Treatment of Dupuytren’s contracture with dermofasciectomy

Abstract

The use of a full thickness skin graft to cover a palmar defect remaining after surgical excision of diseased Dupuytren’s tissue, also known as dermofasciectomy, has been employed for both management of diffuse and recurrent disease. Heuston was one of the first authors to describe management of recurrent Dupuytren’s in the 1960s (Hueston, PlasReconstr Surg 31:66-69, 1963). His classic article notes a clear distinction between recurrence at the primary surgical location and extension into the surrounding tissue. This chapter offers the example of a 59-year-old right hand dominant male as an illustrative case of management with dermofasciectomy of recurrent Dupuytren’s disease following previous fasciectomy. A full thickness skin graft was harvested from the hairless surface of the medial brachium of the ipsilateral arm and sutured in place in the distal left palm where the recurrent disease had been excised. Three-month follow-up demonstrated improved strength, motion, and return to recreational golf. Final follow-up was 3 years post skin graft with no evidence of disease recurrence in the distal left palm.