What do I have to regard during the aftercare of Dupuytren's Contracture?

First of all, the aftercare after the surgery of Morbus Dupuytren is very important.
It would be ideal if the aftercare is supervised from a department for hand surgery.
Supervision from the hand surgeon who performed surgery of your hand is appropriate if you suffer from:

• increasing pain

• large swelling of the hand

• immobility of the hand

• skin necrosis

How long do I have to wear a bandage after surgery of Morbus Dupuytren?

During the first week after a surgery of Dupuytren's Contracture we stabilise the hand by means of a splint.

After one week we use a well cushioned compression bandage in order to prevent you from further swellings.

You can move your fingers in both bandages

In general one can say that you have to wear the bandage until the wounds have closed and have stopped to secrete ichor.

For most of the patients this means a period of three to four weeks unless the bandage is no longer required.

When will the stitches been taken out?

In most of the cases about two weeks after surgery.

Is it necessary to attend physiotherapy after the surgery?

Every patient should move the fingers as soon as possible and after consultation with the attending physician. Many patients do so well that they can form a fist and extend the fingers three weeks after the surgery. These patients do not need a physiotherapy.

If a patient has problems with the autonomous exercises and the mobility of his hand stays below average it is important to attend physiotherapy.

What is important to keep in mind for a patient attending physiotherapy?

Most important is that physiotherapy never leads to pain and swellings in the affected hand!
A physiotherapy that is too hard for the patient is contraindicated.

You should change your physiotherapist if you recognise that you are not treated according to your individual needs.

When can I use my hand like I am used to do?

You should use and train your hand step by step after the surgery.

Do not overdo it, otherwise you will suffer from pain and swellings.

Casual and job-related stress on the affected hand can been taken after six weeks by most of the patients.
Extreme stress, like playing tennis or golf, shall be avoided ten to twelve weeks after surgery of Dupuytren's Contracture.

What can I do to support the recovery of my hand?

A good advice is to use rich cream several times a day for the first months after the surgery.
After the removal of the bandages it is helpful to bath the affected hand 5 minutes 5 times a day in warm water. Continue day by day until the mobility of the hand is re-established.
Do not forget to use the rich cream after the hand bath.

Are the scars very obvious?

Most of the scar tissue at the hand is hard to see after 12 to 18 months. Permanently disturbing scars in the palm are quite rare if the right cutting technique was used.
Important:
Scars on the hand are very sensitive in the first weeks and months after surgery. During this time the scar looks bulging and light red. This may last for six months after the surgery of Dupuytren's Disease.

Can I suffer again from Dupuytren's Disease after a surgery?

Yes, this can unfortunately happen. We distinguish between a new affection of the hand and a relapse.
New affection: The tissue was removed from the little finger and now the middle finger is affected.
Relapse: The tissue was removed from the little finger and now the same finger is affected.

You have a higher risk to suffer from a relapse if surgery takes place on the fingers instead of the palm.
It is important to know that the hand surgeon can "only" remove the excrescent tissue, he can not cure the disease by changing the genetic disposition.

What affects my individual risk to suffer from a relapse of Morbus Dupuytren?

The probability to suffer from a relapse increases if one or more of the mentioned factors fit on you:

• a first-grade relative also suffers from Dupuytren's Contracture

• you are also suffering from excrescence of tissue at the foot, penis or knuckle

• the disease established before your 40th birthday

• the disease affects thumb and/or forefinger