Long-term Effects of Skin Tearing on Outcomes After Collagenase Treatment of Dupuytren Contractures.

Abstract

<b>Background:</b> The objective of this study was to compare the rates of recurrence, additional treatment, patient satisfaction, and willingness to undergo <i>Clostridium histolyticum</i> (CCH) treatment again for Dupuytren disease in patients with and without skin tearing at minimum 5-year follow-up. <b>Methods:</b> We identified 199 digits in 142 patients who underwent CCH treatments for Dupuytren disease from April 2010 to December 2013 with minimum 5-year follow-up. Patients were contacted by telephone to collect our response variables: perceived recurrence of contracture, additional treatment, satisfaction, and willingness to undergo CCH treatment again. Medical records were reviewed for skin tearing at manipulation and patient-related and disease-specific variables. <b>Results:</b> At the time of manipulation, 16 out of 142 patients (11%) and 22 out of 199 digits (11%) had skin tearing. Older age was associated with skin tearing. At an average 7.2-year follow-up, the mean satisfaction was 7.1 ± 2.6 on a 1 to 10 Likert scale for patients with skin tearing and 6.5 ± 3.4 for patients without skin tearing. Eighty-one percent of patients with skin tearing expressed willingness to undergo CCH treatment again, compared with 68% of patients without skin tearing. Perceived recurrence of contracture occurred in 82% of digits with skin tearing and 80% of digits without skin tearing. Additional treatment was performed in 45% of digits with skin tearing and 54% of digits without skin tearing. No difference was statistically significant. <b>Conclusions:</b> Although skin tearing at CCH manipulation complicates the short-term course following CCH treatment, it does not affect long-term perceived contracture recurrence or patient satisfaction.