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

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

Abstract

INTRODUCTION: Fibrin glue (FG) can be applied in several surgical procedures at wound closure to reduce postoperative complications such as 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: One hundred and thirty-three 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 toward higher wound healing impairment (13%, p = 0.07). The FG group showed a significantly higher pooled complication 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 overall 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.

Details

Original languageEnglish
Pages (from-to)291-297
Number of pages7
JournalJournal of Plastic, Reconstructive & Aesthetic Surgery
Volume77
Early online date24 Nov 2022
Publication statusPublished - Feb 2023
Peer-reviewedYes

External IDs

Scopus 85146230127
Mendeley 66189ac3-5445-37e1-a857-d34dff57c7b6
ORCID /0000-0003-4633-2695/work/142251231

Keywords

ASJC Scopus subject areas

Keywords

  • Aponeurectomy, Dupuytren's disease, Fasciectomy, Fibrin glue, Hand surgery, Postoperative Hemorrhage, Humans, Neoplasm Recurrence, Local, Fasciotomy, Fibrin Tissue Adhesive/therapeutic use, Hematoma/etiology, Dupuytren Contracture/surgery, Postoperative Complications/epidemiology, Retrospective Studies

Library keywords