Volume 30, Issue 175, September 2026

Management of Mitten-Glove Hand Deformity in Recessive Dystrophic Epidermolysis Bullosa: A Narrative Review of Surgical, Rehabilitation, and Adjunctive Treatment Strategies

Mikołaj Cezary Krajewski^4♦, Jakub Papierz¹, Katarzyna Cybulska¹, Julia Banaszczyk¹, Stanisław Janczarski¹, Gabriela Królczyk³, Aleksandra Pietrzyk²

¹Institute of Dentistry of the Central Clinical Hospital of the Medical University of Łódź, Pomorska 251, 92-213 Łódź, Poland
²Centralna Wojskowa Przychodnia Lekarska CePeLek SPZOZ, 78 Koszykowa Street, 00-911 Warszawa, Poland
³Zespół Przychodni Specjalistycznych Sp. z o.o., 1 Skłodowskiej-Curie Street, 33-100 Tarnów, Poland
⁴University Hospital Martin, Kollárova 2, 036 59 Martin, Slovak Republic

^♦Corresponding author
Mikołaj Cezary Krajewski, University Hospital Martin, Kollárova 2, 036 59 Martin, Slovak Republic

ABSTRACT

Introduction and Objective: Recessive dystrophic epidermolysis bullosa (RDEB) is a serious hereditary condition (mutations within the COL7A1 gene) characterized by chronic inflammation, where the skin is prone to the development of chronic wounds, scarring, and fibrosis that, in the final state, lead to progressive syndactyly, thumb adduction contractures, and mitten hand deformities. This article highlights the latest surgical techniques, rehabilitation methods, and additional therapies, focusing on patients' autonomy, caregiver burden, and social engagement. Methods used for the literature review in academic style: A thorough literature review was performed to extract data from journals, guidelines, and regulations of regulatory organizations for the period 1992-May 2026. The literature review concentrated on such themes as RDEB, hand surgery, dressings, splints, occupational therapy, physiotherapy, wound care, pain control, and wound healing innovations. Current Status: Surgery produces improvements in function regarding grasping and pinching functions but has a high recurrence rate due to skin fragility and scar formation associated with wound healing. Outcomes rely on proper wound care, minimizing trauma through splinting after surgery, hand therapy, education of caregivers, pain management, and the functional use of the hand. Current wound healing approaches make it possible for wounds to heal but do not reverse existing contractures or pseudosyndactyly. Conclusion: Management of the mitten-glove hand in RDEB must be multidirectional, involving surgical management, rehabilitation, occupational retraining, and other adjunctive treatments in order to reduce the burden of the wound and restore function.

Keywords: recessive dystrophic epidermolysis bullosa; mitten-glove hand; pseudosyndactyly; hand surgery; rehabilitation; wound healing

Medical Science, 2026, 30, e195ms3960

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Published: 25 September 2026