Ansari Saif Akhter, Kennedy James Andrew, Younis Fizan
Department of Hand Surgery, East Lancashire Hospitals National Health Service Trust, Lancashire, United Kingdom.
Health Education North West Trauma and Orthopaedics, Health Education North West, Lancashire, United Kingdom.
J Hand Microsurg. 2021 Mar 23;14(1):71-78. doi: 10.1055/s-0041-1726673. eCollection 2022 Jan.
Early review of skin graft following dermofasciectomy with skin grafting for Dupuytren's disease is not standard practice because of the potentially adverse effects on inosculation and neovascularization process of the skin grafting. The purpose of this retrospective case series was to observe whether early review of grafts postoperatively at 48 hours adversely affects graft survival and surgical outcomes. Forty-nine primary and revision procedures were retrospectively analyzed for treatment outcomes, postoperative complications, functional hand scoring, and satisfaction rates postoperatively. Thirty-eight patients were treated successfully with no postoperative contracture. There were three treatment failures and two graft failures, with two amputations within these failures. Paired pre- and postoperative Unité Rhumatologique des Affections de la Main scoring demonstrated significant improvement in hand function for primary procedures, with a mean satisfaction score of 7.7 out of 10. We have shown early graft review following dermofasciectomy and full-thickness skin grafting to be safe, allowing early mobilization and splinting, with our postoperative failure and complication rate being within published literature.
由于对植皮的吻合和新生血管形成过程可能产生不利影响,在进行Dupuytren病的筋膜切除术并植皮后进行早期植皮检查并非标准做法。本回顾性病例系列的目的是观察术后48小时对植皮进行早期检查是否会对植皮存活和手术结果产生不利影响。
对49例初次手术和翻修手术的治疗结果、术后并发症、手部功能评分和术后满意率进行了回顾性分析。
38例患者治疗成功,术后无挛缩。有3例治疗失败和2例植皮失败,其中2例在这些失败病例中行截肢术。配对的术前和术后手部风湿病协会评分显示,初次手术的手部功能有显著改善,平均满意度评分为7.7分(满分10分)。
我们已经证明,在筋膜切除术和全厚皮片移植后进行早期植皮检查是安全的,可实现早期活动和夹板固定,我们的术后失败率和并发症发生率在已发表的文献范围内。