Source: Clostridium histolyticum
Brand name: Xiaflex
Indication: adult with palpable Dupuytren’s disease cord causing significant flexion contracture
Collagenase (0.58 mg) is injected into each cord with passive digital extension 24 hours later to cause rupture of the cord. There is followup at 1, 7 and 30 days. The patient performs 4 months of extension exercises and uses an extensions splint at night.
Each cord can have up to 3 treatment cycles.
Conditions that may prevent therapy:
(1) history of allergic reaction to collagenase in past
(2) bleeding disorder
(3) therapeutic anticoagulation within past 7 days (except low dose aspirin)
(4) pregnancy
(5) adequate training of the physician
Complications:
(1) allergic reaction, especially after multiple injections
(2) tendon rupture
(3) injection site reactions (hemorrhage, pain, edema, etc)
(4) proximal lymphadenopathy
(5) possibly complex regional pain syndrome
(6) recurrence of contracture
(7) skin laceration
