Dupuytren's Skin Graft Controversy

Skin grafting is a time honored technique in the range of options to reduce the incidence of recurrence after fasciectomy for Dupuytren's contracture. There are two general approaches. One is dermofasciectomy: remove a large area of affected skin and resurface the area with a similarly large skin graft. The other is to put in a smaller skin graft to break up the line of pull of the original cord, a firebreak skin graft. Several studies have documented the superiority of dermofasciectomy over fasciectomy, but what about firebreak grafts? Hot off the press, a controlled study http://www.ncbi.nlm.nih.gov/pubmed/19258615?dopt=Abstract reports that fasciectomy with firebreak skin graft doesn't improve results compared to fasciectomy alone. Hmmmph!

Genetic studies are underway for Dupuytren's

The goal of the collaboration of the Dupuytren Foundation and Scripps Research is to identify the genes responsible for Dupuytrens and then develop a targeted intervention to make them stop doing that. Our DNA is like a computer, and our genes are the programs that are either running (upregulated) or not running (downregulated). The genes that result in Dupuytren's are chromosomal malware - a bad program or bad programs. Progress is being made http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2377253&blobtype=pdf with a small number of samples. The Scripps DNA project anticipates a DNA sample selection 10 to 100 times larger than what has been previously available. The future looks bright. We will find a cure.

Hand therapy and splinting are usually a big part of recovery after open surgery for Dupuytren's contracture. Despite a drive for evidence based medicine, evidence for the effectiveness of splinting after open Dupuytren's surgery is still elusive. Debbie Larson and Christina Jerosch-Herold review the issue in this article (link to full text pdf): Clinical effectiveness of post-operative splinting after surgical release of Dupuytren's contracture: a systematic review

Dupuytren's Foundation and Scripps Research

The Dupuytren's Foundation http://www.dupuytrenfoundation.org has officially partnered with Scripps research to establish a DNA bank of tissues affected by Dupuytren's disease. This will be available to researchers interested in studying Dupuytren DNA. So far, 20 samples have been collected. If the gene is identified, progress toward acure will be greatly streamlined. Very exciting. Interested in donating your DNA to the cause? Contact The Hand Center http://www.handcenter.org 561-746-7686