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WOUND HEALING AFTER HAND SURGERY IN PATIENTS WITH SYSTEMIC SCLEROSIS—A RETROSPECTIVE ANALYSIS OF 41 OPERATIONS IN 19 PATIENTS

From the Hand and Upper Extremity Unit, Department of Orthopaedics, Lund University Hospital, Lund, Sweden and the Department of Orthopaedics, Ängelholm Hospital, Ängelholm, Sweden

Correspondence: Dr Jan Dieterich, MD, Department of Orthopaedics, Ängelholm Hospital, 262 81 Ängelholm, Sweden. Tel.: +46 42 322542; fax: +46 42 102410. E-mail:jandie{at}gmx.net

This retrospective study evaluates the results of 41 consecutive hand and forearm operations in 19 patients with systemic sclerosis performed between 1985 and 2000. The mean age of the patients was 50 (14–84) years. Twenty-seven operations were elective and 14 were acute, carried out for skin breakdown and/or skin necrosis. One minor wound healing problem occurred in the elective group. In the acute group, seven of 14 operations healed uneventfully. Four patients had necrosis/infections after surgery, which required further surgery. Two patients had repeated wound infections. Another patient only healed after he stopped smoking. In systemic sclerosis, surgery performed electively does not seem to have increased difficulty with wound healing. Even larger operations, such as wrist arthrodesis or wrist replacement, can be performed safely. In acute cases with spontaneous skin breakdown and/or necrosis and/or critically ischaemic fingers, wound healing is more precarious and several procedures may be necessary to achieve skin healing.

Key Words: sclerodermia • systemic sclerosis • hand surgery • impaired healing • wound healing

Journal of Hand Surgery (European Volume), Vol. 32, No. 3, 316-319 (2007)
DOI: 10.1016/J.JHSB.2006.12.006


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