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Application of fibrin glue for hematoma prophylaxis in selective aponeurectomy in Dupuytren's disease.

  • Author Footnotes
    ⁎ shared first authorship
    Bassem Daniel
    Footnotes
    ⁎ shared first authorship
    Affiliations
    UNIVERSITY MEDICAL CENTER FREIBURG, Department of Plastic and Hand Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisgau, Germany.
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  • Author Footnotes
    ⁎ shared first authorship
    Kim Schmid
    Footnotes
    ⁎ shared first authorship
    Affiliations
    UNIVERSITY MEDICAL CENTER FREIBURG, Department of Plastic and Hand Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisgau, Germany.
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  • Horst Zajonc
    Affiliations
    UNIVERSITY MEDICAL CENTER FREIBURG, Department of Plastic and Hand Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisgau, Germany.
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  • Steffen Eisenhardt
    Affiliations
    UNIVERSITY MEDICAL CENTER FREIBURG, Department of Plastic and Hand Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisgau, Germany.
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  • Adrian Dragu
    Affiliations
    Department of Plastic and Hand Surgery, UniversityCenter of Orthopedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at the TU Dresden, Germany.
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  • Seyed Arash Alawi
    Correspondence
    Corresponding Author.
    Affiliations
    Department of Plastic and Hand Surgery, UniversityCenter of Orthopedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus at the TU Dresden, Germany.
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  • Author Footnotes
    ⁎ shared first authorship
Published:November 23, 2022DOI:https://doi.org/10.1016/j.bjps.2022.11.015

      Summary

      INTRODUCTION

      Fibrin glue (FG) can be applied in several surgical procedures at wound closure to reduce postoperative complications, like hematoma formation and wound impairment. The purpose of this study is to assess these preventive surgical benefits in Dupuytren's disease of the hand.

      PATIENTS AND METHODS

      We performed a monocentric retrospective cohort study. All patients who underwent selective aponeurectomy for Dupuytren's disease between 2010 and 2020 were included. Patients were divided into two groups either receiving or not receiving FG. The primary outcome variables were postoperative bleeding, wound healing impairment and further pooled postoperative complications.

      RESULTS

      133 patients were included in the analysis of which 108 patients were treated with FG while 24 did not. There was no statistically significant difference in outcomes regarding postoperative bleeding, infections or revision surgery. However, in the group receiving FG, there was a tendency to higher wound healing impairment (13%, p=0.07). The FG group showed a significantly higher pooled complications’ rate (18.5%, p<0.02). Complication in general increased with higher Tubiana classification and number of resected cords. Smoking tripled the risk of impaired wound, while cardiovascular comorbidities increased postoperative bleeding by the factor of 11.

      CONCLUSION

      FG did not show a preventive outcome regarding bleeding. The FG group had a tendency for a higher wound healing incidence. Smoking and arterial hypertension correlated with a higher postoperative complication rate. The all-over incidence of complications was higher in the FG group. The quality of the surgical intervention as well as accurate hemostasis cannot be corrected by the application of FG.

      Keywords

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