Current Trends in the Treatment of Dupuytren Disease in Spain

Abstract

Objective Assessment of the treatment trends of Spanish surgeons in clinical practice by making clinical assumptions in Dupuytren's disease (DD). Material and Method A survey was sent to the members of the Spanish Society for Surgery of the Hand (Sociedad Española de Cirugía de la Mano, SECMA) posing primary and secondary clinical cases. A relationship is established between the selected treatment, the characteristics of the participating surgeons, and the characteristics of the primary clinical cases. Treatment preferences in recurrences are assessed descriptively. Results In total, 127 surveys were answered. 62.2% of the participants had experience with the use of collagenase and were the basis of the analysis. In primary cases, surgeons with more practice time tended to choose collagenase as treatment for DD. Surgeons who reported higher frequency of collagenase use (67.4% vs. 25.7%) were up to 6 times more likely to indicate such treatment. The patient's age under 50 years was the variable with the greatest association strength for the choice of collagenase treatment (OR = 3.8; CI95% 1.9–7.6). In recurrences, among all clinical cases, the most common answer given by the surgeons was partial fasciectomy. Conclusions Partial fasciectomy continues to be the most widely used treatment for DD in Spain. In primary cases, collagenase is an alternative adopted by experienced surgeons, and in treatments for young patients. In recurrences, partial fasciectomy is the preferred technique.

Initial Treatment Choice Affects Cost-Effectiveness and Reintervention Rates for Dupuytren Contracture: A National Census Among Veterans Affairs Patients

“…19,20 As a result, individual surgeons may be less likely to offer other treatment options for DD. 20,21 Within the VA system, the comparable reintervention rate to CCH and low initial treatment cost of PNA suggest that PNA may be the ideal treatment for symptomatic patients who are a candidate for a minimally invasive treatment of their DD. Providing additional training in the use of PNA for less-experienced surgeons could potentially be a cost-effective strategy, if this causes the surgeons to favor PNA over CCH in cases where both treatments are viable options.…”