Villani F, Choughri H, Pelissier P
Centre François-Xavier-Michelet, service de chirurgie plastique et main, groupe hospitalier Pellegrin, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
Chir Main. 2009 Dec;28(6):349-51. doi: 10.1016/j.main.2009.08.006. Epub 2009 Sep 11.
The aim of the study was to evaluate the ability of full thickness skin grafts to prevent recurrence of aggressive Dupuytren's contracture.
Eighteen patients presenting with bilateral recurrent Dupuytren's contracture were identified and retrospectively reviewed with a mean follow-up of 8.8 years after dermofasciectomy and skin grafting onto at least one hand.
Only two patients presented with a complete diathesis of Dupuytren's contracture, such as defined by Hueston, thus confirming that recurrence is still not predictable. Each patient sustained 3.6 procedures on average. Thirteen patients were skin grafted on a single hand and five patients bilaterally. Recurrence occurred in three instances after skin grafting and in all instances when skin graft was not performed. Finally, three peroperative and five postoperative complications were reported.
Skin grafting was able to prevent further recurrence of recurrent Dupuytren's contracture in 20 out of 23 hands with more than 8 years of follow-up. Since recurrence is still difficult to predict, primary skin grafting remains controversial. Indications for the procedure are more definite once recurrence has occurred.
本研究旨在评估全厚皮片预防侵袭性掌腱膜挛缩复发的能力。
确定18例双侧复发性掌腱膜挛缩患者，并对其进行回顾性研究，这些患者在至少一只手进行了真皮筋膜切除术和植皮术后平均随访8.8年。
只有2例患者出现了如休斯顿所定义的掌腱膜挛缩完全素质，从而证实复发仍然无法预测。每位患者平均接受3.6次手术。13例患者单手植皮，5例患者双手植皮。植皮后有3例复发，未进行植皮的所有病例均复发。最后，报告了3例术中并发症和5例术后并发症。
在23只手中，有20只手在随访超过8年时，植皮能够预防复发性掌腱膜挛缩的进一步复发。由于复发仍然难以预测，原发性植皮仍然存在争议。一旦复发发生，该手术的适应症就更加明确。
