Extensive Percutaneous Aponeurotomy and Lipografting |
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03/11/2012 05:50
romfordboy
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03/11/2012 05:50
romfordboy
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Extensive Percutaneous Aponeurotomy and Lipografting
I saw this recently on WikiPedia and thought it may be of great interest.
I had a conversation with David Hunter Smith about treatments 4 years ago while he was treating my hands and he said that he was investigating a treatment that sounds very similar to this but using Pig Tissue.
Here is the wiki article:
Extensive Percutaneous Aponeurotomy and Lipografting
A recently introduced technique to treat Dupuytren disease is extensive percutaneous aponeurotomy with lipografting.
This procedure also uses a needle to cut the cords. The difference with the percutaneous needle fasciotomy is, that with this procedure the cord is cut at many places. The cord is also being separated from the skin to make place for the lipograft that is taken from the abdomen or ipsilateral flank.This technique is very promising, because it shortens the recovery time, also the fatgraft results in supple skin.
Before the hand is operated, a liposuction is done to the abdomen and ipsilateral flank to collect the lipograft. The treatment can be performed under regional or general anesthesia. The digits are placed under maximal extension tension using a firm lead hand retractor. Then the surgeon makes multiple palmar puncture wounds with small nicks. The tension on the cords is crucial, because tight constricting bands are most susceptible to be cut and torn by the small nicks, whereas the relatively looser neurovascular structures are spared.
After the cord is completely cut and separated from the skin the lipograft is injected under the skin. A total of about 5 to 10 ml is injected per ray.
After the treatment the patient has to wear an extension splint for 5 tot 7 days. After this 1 week of postoperative splinting the patient is allowed to return to his normal activities and he is advised to use a night splint for up to 20 weeks.
At this moment this treatment is only performed in Miami or in Rotterdam. Prospective randomized studies with other techniques are in process to fully determine its role in the treatment of Dupuytren’s disease
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03/11/2012 08:34
wach Administrator
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03/11/2012 08:34
wach Administrator
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Re: Extensive Percutaneous Aponeurotomy and Lipografting
You might also watch the presentation by Roger Khouri at the 2010 Miami conference on Dupuytren's Disease http://www.youtube.com/watch?v=fmWiC5V76YI&lr=1.
Wolfgang
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