Dupuytren’s Fasciectomy is usually carried out under general anaesthetic. Your surgeon will make several types of incisions most likely along the natural creases and lines in the hand. This will help make the scar less noticeable once the hand is healed. Once the palmar fascia is exposed, it will be carefully separated from nerves, arteries, and tendons. Special care is taken not to damage the nearby nerves and blood vessels. Then your surgeon will remove enough of the diseased palmar fascia to allow you to straighten your finger(s).
After the diseased tissue is removed the jointcapsule or the ligaments of the joint may be stiffened or contracted. Therefore the surgeon may also need to release this tissue in order to allow the finger to straighten up normally. Once the fibrous tissue is removed, the skin is sewn together with fine Prolene sutures and a dressing is applied.
A skin graft may be needed if the skin surface has contracted so much that the finger cannot relax as it should and the palm cannot be stretched out flat. Your surgeons will graft skin from the wrist, elbow, or groin.
Following your Dupuytren's fasciectomy, your hand will be bandaged with a well-padded dressing and a splint for support after surgery. You will see the hand therapist five days following your operation for a further plastic splint. You will spend a further two weeks in the splint and then start fully mobilising out of the splint. You will wear a splint at night for six months in total. The splint will keep the hand open and the fingers straight during healing. Because many nerves are found in the hand, you may have some discomfort after surgery. You will be given pain medicine to control the discomfort.
The sutures will be removed by the outpatient nurses two weeks after the surgery.
After the operation you should keep your hand elevated above the level of your heart for several days to avoid swelling and throbbing. Keep it propped up on a stack of pillows when sleeping or sitting up.
Hand therapy can make the difference in a successful result after surgery. These sessions are important in limiting the buildup of scar tissue, preventing the return of contractures, and getting the most benefit from surgery.