The risk of skin tear in Dupuytren's disease when treated with collagenase.

INTRODUCTION: The purpose of this study was to explore if there was a correlation between joint level and degree of contracture on the one hand and the risk of skin tear in Dupuytren's disease (DD) on the other, when treated with collagenase from Clostridium histolyticum. No trial or study has explored the risk of skin tear as primary outcome in a population that has not been treated for DD before.

METHODS: A retrospective study of prospectively collected data was performed on patients with DD treated with collagenase from 1 August 2012 to 1 April 2014. Skin tear was classified as "Yes" or "No" and not quantified by tear size for further analysis.

RESULTS: A total of 105 contractures in 90 patients with DD were included. In all, 77 contractures at the metacarpophalangeal (MP) joint and 28 at the proximal interphalangeal joint (PIP) joint. A total of 59 contractures experienced skin tear. The relative risk (RR) of skin tear was 1.5 for an MP joint of ≥ 60° contracture compared with an MP joint at 20-59° (p = 0.17). The RR of skin tear was 2.2 for a PIP joint of ≥ 60° contracture compared to a PIP joint of 20-59° (p = 0.04). The RR for skin tear was 1.1 for an MP joint compared with the PIP joint (p = 0.74). The RR for skin tear was 1.7 for contractures of ≥ 60° compared to 20-59° regardless of level (p = 0.01).

CONCLUSIONS: There is a significantly higher relative risk of skin tear when the contracture is ≥ 60° and when the contracture is ≥ 60° and located at the PIP joint. The most important factor regarding the risk of skin tear is the degree of the contracture.

FUNDING: none.

TRIAL REGISTRATION: approved by the Danish Data Protection Agency.