Dermofasciectomy and Skin Graft for Dupuytrens contracture therapy
See information on Needle Fasciotomy for Dupuytrens at www.needledup.com
Two weeks:
The postoperative dressing, sutures and joint pins are removed.
Dressing and immobilizing splint are reapplied.
Four weeks:
Active and Passive Range of Motion exercises are initiated 6 times /
day
for 15 minute sessions.
Recommendations regarding skin graft moisturizing and protection from
shearing forces and direct trauma are reviewed.
A Dupuytren's splint is fitted in full extension only at night. When
multiple digits are involved, a full extension Resting Pan splint is
indicated.
A Web Spacer is fitted when palmar tissue has been removed from the 1st
web space.
A silicone elastomer insert may be fitted beneath the splint once the
wound has healed to provide compression to the scar and reduce
hypertrophy.
Electrical muscle stimulation may be used as needed to facilitate
tendon
excursion once the edema has subsided.
Taping and/or dynamic flexion splinting may be initiated to increase
Passive Range of Motion as needed.
A stress loading program is initiated and the physician is notified if
the
patient develops signs of vasomotor instability, excessive sweating,
temperature change, worsening pain or progressive stiffness and
swelling.
Daytime splinting may be used for outdoor protection at the patient's
discretion.
6 weeks:
Daytime splinting is discontinued.
8 weeks:
Strengthening is initiated when pain and swelling are not a minimum and
the wounds have healed (foam, putty, hand helper).
Night splinting is continued for six to twelve months postoperatively.
See information on Needle Fasciotomy for Dupuytrens
at www.needledup.com
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