Pain Associated With Treatment of Dupuytren Contracture With Collagenase Clostridium histolyticum

Adipose-derived stem cell research, worry and hope

“…You are right about what is said in the training for CCH administration but our views are also shared by other authors 2,3,6,8 and, in our opinion, the pain encountered in patients required some actions.…”

“…In our study, LA is used proximal to the injection site so to avoid mixing CCH with LA. About the possibility of injection CCH inside a nerve, there are no cases describing this problem in the reviews of secondary effects of the drug, 4,6,8 And there seems to be no negative effects on the nerve with the effect the drug has on the myelin sheath. 5 So, probably the cases of severe pain after injection are more related to fibrosis occurring around the injection site.…”

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

“…Indeed, we compared the results of using or not using local anesthesia (LA) before injection and found that those not using LA had very intense pain scores (NRS with a value of 10). 6,8 In this paper, we found a relationship between pain scores during injection and extension and as a consequence less pain implies less traumatic experience. As we already know, pain is a reason for greater dissatisfaction in patients undergoing treatment with CCH as it has already been shown by Bradley in his survey.…”

A systematic review identifying outcomes and outcome measures in Dupuytren’s disease research

“…mean, median). For example, Sanjuan-Cervero (2017) used a numerical rating scale ranging from 0 to 10 to ‘assess treatment-related discomfort’ and reported the number and percentage of patients who reported a rating above 3, as this was determined to be the threshold value for discomfort.…”