Anesthesia for collagenase clostridium histolyticum injection in patients with dupuytren disease: A cohort analysis

Sanjuán-Cerveró, Rafael; Carrera-Hueso, Francisco Javier; Vázquez-Ferreiro, Pedro; Peimer, Clayton A.

doi:10.1016/j.bjps.2018.03.016

Cited by 8 publications

(6 citation statements)

References 23 publications

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“…[18][19][20] The treatment protocol did not include anesthetic before injection, 5 which has been found to reduce pain. 19,21 Procedural pain can deter patients from seeking treatment again, as indicated by three study participants and 23 percent of participants in previous research. 20 Participants in this study and in previous research demonstrated varied knowledge about Dupuytren disease.…”

Section: Discussionmentioning

confidence: 99%

“Extremely Painful, but Worth It”: The Lived Experience of Receiving Collagenase as Treatment for Dupuytren Disease

Molineux

McCann

Cox

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Collagenase injection is a relatively new, minimally invasive treatment option for Dupuytren disease. Most literature focusses on quantitative outcome measures, such as degree of residual contracture and recurrence. The patient experience of the treatment has rarely been explored. This study sought to explore patients’ experiences of the treatment process, including their reasons for seeking and choosing the treatment. Methods: A qualitative descriptive design was used to explore patients’ experiences. Seven patients (aged 57 to 81 years) who had received collagenase treatment for Dupuytren disease engaged in individual, semistructured interviews. Interviews were audio recorded, transcribed verbatim, and analyzed thematically. Results: Thematic analysis revealed that Dupuytren disease was an obstacle to doing things, but not a barrier. Patients “went with the flow” of treatment, often taking a passive approach to their health care decisions. Patients found the collagenase injections to be extremely painful, but worth it. They had a varied knowledge of the disease and treatment. Conclusions: Patients were pleased with the results of the collagenase treatment, even if the finger was not completely straight or there was recurrence. The quick recovery and minimal complications were positive factors; however, the injections were extremely painful and could deter patients from future treatment. This research highlighted that a number of patients had low health literacy regarding their condition, and this affected their expectations of treatment outcomes and future treatment seeking. There are opportunities for health professionals to improve health literacy for people with Dupuytren disease, possibly in a group setting.

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Section: Discussionmentioning

confidence: 99%

“Extremely Painful, but Worth It”: The Lived Experience of Receiving Collagenase as Treatment for Dupuytren Disease

Molineux

McCann

Cox

et al. 2022

Plastic &Amp; Reconstructive Surgery

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show abstract

“…There seems to be a relationship between a patient’s level of pain during injection and the likelihood that the patient will experience pain during manipulation [33]. A wrist block before a collagenase injection can reduce perceived pain and potentially increase patient satisfaction [34]. However, increased pain does not persist for a long time as the average VAS score was around 1 for the 7–365-day FU.…”

Section: Discussionmentioning

confidence: 99%

Prospective observation of Clostridium histolyticum collagenase for the treatment of Dupuytren’s disease in 788 patients: the Austrian register

Arora

Angermann

Paul

et al. 2019

Arch Orthop Trauma Surg

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Introduction Since March 2011, the microbial collagenase of Clostridium histolyticum ( Xiapex®, Swedish Orphan Biovitrum AB, Stockholm, Sweden) has become available in the European Union for treatment of Dupuytren’s disease. The purpose of this study was to evaluate potential safety risks of Xiapex® and to contribute to a better understanding for its use. Methods A prospective, non-interventional, observational study using Xiapex® for Dupuytren’s disease named XIANIS was conducted between 1.10.2011 and 01.10.2017. Treatment was conducted in accordance to the manufacturer information. Patients were invited for follow-up after 1 week, 1 month, 3 months and 1 year. Demographic data, treatment data, pain levels, anaesthetic application during passive manipulation, subjective function improvement, subjective satisfaction and adverse events were recorded. Results 788 patients with 814 treatments were included who suffered from Dupuytren’s contracture for a mean of 64 months. The metacarpophalangeal joint was affected in 57% of cases and the PIP joint in 40.8% with a mean contracture of 39° and 56°, respectively. A change in the contracture down to 0°–5° was reported in 66.5% of cases, while 25.5% achieved a partial improvement. The pain during the injection was rated 4.5 and 3.3 during passive manipulation. Adverse events were reported in the majority of treated patients with skin tears being one main common event (26%). Further adverse outcomes were bleeding/hematoma, joint swelling, injection-site swelling, pressure sensitivity, erythema, injection-site pain, peripheral edema, blood blisters, blisters, painless lymphadenopathy, painful lymphadenopathy, axillary pain, arthralgia and sensory abnormality. There were no reported tendon ruptures, anaphylactic reactions or ligament injuries. On 1-year follow-up, 29% showed an increased contracture of a mean of 24° with the need for surgical treatment in 2% of patients. 74% of patients were very satisfied and 72% showed a high functional improvement. Conclusion The injectable collagenase Clostridium histolyticum (Xiapex®) proved to be effective and safe in patients with Dupuytren’s disease. Minor adverse events disappeared within 30 days and the need for surgical treatment within 1 year was very low (2%). No major complications or rare side effects were seen in this prospective observational study.

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“…1 It is true, that pain associated with a wrist block was not evaluated in our study. We mentioned this as a limitation in our study, 7 but the purpose of our study was to evaluate pain experienced during injection and extension and find out whether getting lower pain values in the first could also be achieved in the latter. The data Mr. Henderson require is provided in the paper by Nordenskjöld 3 with a VAS value of 2.9 (nonpathological parameter < 3).…”

Section: Aerosol-related Thermal Injuries: a Simple Approach To Managmentioning

confidence: 96%

Response to the comment of Mr. J. Henderson on paper “Anaesthesia in the colagenase clostridium histolyticum injection for Dupuytren's disease: A cohort analysis”✰

Sanjuán-Cerveró

2019

Journal of Plastic, Reconstructive & Aesthetic Surgery

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Anesthesia for collagenase clostridium histolyticum injection in patients with dupuytren disease: A cohort analysis

Cited by 8 publications

References 23 publications

“Extremely Painful, but Worth It”: The Lived Experience of Receiving Collagenase as Treatment for Dupuytren Disease

“Extremely Painful, but Worth It”: The Lived Experience of Receiving Collagenase as Treatment for Dupuytren Disease

Prospective observation of Clostridium histolyticum collagenase for the treatment of Dupuytren’s disease in 788 patients: the Austrian register

Response to the comment of Mr. J. Henderson on paper “Anaesthesia in the colagenase clostridium histolyticum injection for Dupuytren's disease: A cohort analysis”✰

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