Dermofasciectomy
When would I have a dermofasciectomy?
If there is significant skin involvement with Dupuytren's Disease, the diseased skin has to be excised and a procedure known as dermofasciectomy with a skin graft is required.
The use of a skin graft is protective against future recurrences in most cases.
What problems can arise following a dermofasciectomy?
Just like any other operation, a dermofasciectomy for Dupuytren’s contracture can have post operative problems such as bleeding, haematoma formation, infection or delayed healing of the wound.
The sensation at the tips of the fingers can change, the scars can be tight and in time patients can develop a recurrence at the site of surgery or new disease may develop in other parts of the hand which is unrelated to the part that has been operated upon.
The use of a full thickness skin graft is usually protective against a recurrence in the operative area in most cases.
What is the normal postoperative course following a dermofasciectomy?
In the event that a full thickness skin graft has been used, the first dressing is done at seven to ten days following surgery and the rehabilitation and mobilisation programme is conducted at the slightly slower pace than in a simple Fasciectomy in order to allow the skin graft to heal.
As with a simple fasciectomy, most patients will have fine stitches placed in the skin and the hand is placed in a plaster splint. The splint is removed in the week following surgery by the Hand Therapist who then prepare a plastic splint to keep the fingers and thumb stretched. This plastic splint is normally worn at night after the first two weeks and the hand is free during the day to exercise and to use for day to day activities. The plastic splint is normally kept for a period of six months following surgery.
