RESUMO
Therapeutic options to treat Dupuytren`s disease vary considerably. Nevertheless, limited fasciectomy remains the method of choice in advanced disease. Correct incisions are of crucial importance in this kind of surgery.With the inclusion of relevant literature, we present principles of correct incisions and our personal approach in different stages of the disease. History and a subtle clinical examination are essential to plan the surgery. Important details are quality of skin and extent and characteristics of pathological tissue. Generally accepted basic incisions are longitudinal incisions with subsequent Z-plasties and Zig-Zag-Incisions with several modifications. Extensive deficit of skin necessitates local flaps. In the palm we prefer an ulnar-based flap design and in special cases a Z-plasty. Depending on the extent of the disease, various combinations of these basic techniques are necessary. Incisions must respect general principles in hand surgery, allow exposition of the pathological tissue, utilise mobile parts of skin for usage as flaps and respect vascularisation of resulting flaps.In complex cases, individualised incisions or general hand surgical principles and correction of the resulting skin deficit are crucial elements necessary for successful surgery. By sticking to these principles, experienced hand surgeons can implement different solutions.
