Analysis of factors influencing hand function in patients with Dystrophic Epidermolysis Bullosa following surgery

Background: Dystrophic epidermolysis bullosa (DEB) is a hereditary disease characterized by increased fragility of the epidermis and mucosa and is accompanied by blister formation following minor trauma. The patient develops blisters on the skin, which heal after being broken. Repeated injuries cause contracture and scar formation, which can further result in hand deformity, leading to a decline in hand ability and a lower quality of life.It is thus, critical to reconstructing the function and appearance of their hands through surgical manipulation to aid their reintegration into society. Objectives: This study aimed to analyze patients' clinical and follow-up information to investigate the influencing factors of hand function in patients with dystrophic epidermolysis bullosa after the release of scar contracture in both hands. Methods: The hand function of the patients two years after the operation was assessed in accordance with the evaluation criteria formulated by the hand surgery branch of the Chinese Medical Association in 2000. According to the scoring results, the patients were divided into two groups. Those with excellent and good grades were assigned to the open hand function group, and those with poor and poor grades were allocated to the restricted hand function group. The primary conditions, the use of a postoperative hand brace, and some common factors in the two groups were compared to determine whether these parameters influence postoperative hand function. Results: There were no significant differences in age, gender, nationality, body mass index, ADL assessment index, albumin concentration, hemoglobin concentration, fasting blood glucose level, prothrombin time, and activated partial thromboplastin time between the two groups (p>0.05). In contrast, there was a significant difference between the two groups in the use of hand braces following the operation (p<0.05). The odds ratio of patients fixed with a brace compared with patients not fixed with a brace was 11.01. Conclusions: Hand brace is a critical factor impacting the hand function of patients with dystrophic epidermolysis bullosa after scar contracture release in both hands. Indeed, a hand brace worn after the operation can delay the recurrence of scar contracture in both hands and offer patients a longer time to use their hands effectively. Level of Evidence IV