If you suffer from a debilitating hand problem known as Dupuytren's contracture, everyday tasks requiring manual dexterity can pose immense challenges. While surgery can help many people plagued with this condition, conservative treatment methods, including Xiaflex injections, may remove the need for such surgery.
You'll have a clearer idea of how to treat your Dupuytren's contracture as successfully as possible once you gain a basic understanding of what Xiaflex injections involve, how they help, and when to consider this treatment approach over others. Start by reading the following questions and answers about Xiaflex.
What Does Xiaflex Treatment Involve?
Xiaflex, the brand name of a drug called collagenase clostridium histolyticum, works by using enzymes to break down abnormally thickened tissues in the body. Doctors use it for two primary purposes: to relieve Peyronie's disease (which causes a painful curvature of the penis) and a hand problem called Dupuytren's contracture.
In Dupuytren's contracture, the fascia (a connective tissue) beneath the palm of the hand grows unnaturally thick. You may feel modules in the affected palm or fingers, followed by tough cords of tissue that eventually cause your fingers to contract inward into a claw-like configuration.
A plastic surgeon can use Xiaflex to relieve some cases of Dupuytren's contracture by injecting this medication directly into the affected tissues. The enzymes in the drug then go to work breaking down the excess tissue until your fingers resume their former flexibility.
Why Might You Choose Xiaflex Over Other Dupuytren's Contracture Treatments?
Dupuytren's contracture sufferers often undergo hand surgery such as fasciotomy (division of the thickened cords) and subtotal palmar fasciectomy (partial removal of the cords). However, doctors generally recommend these invasive procedures only after conservative treatments have failed to loosen the fascia in the hand.
If you still have early-stage Dupuytren's contracture, with nodules in the palm or fingers as your only symptom, you may opt for steroid injections to reduce inflammation and swelling. If your condition has already advanced to the contracture stage, your doctor will most likely recommend a Xiaflex injection instead.
Who Should Think Twice About Receiving Xiaflex?
Like so many other drugs, Xiaflex doesn't necessarily make good sense for everyone. For instance, some people have allergic reactions to collagenase, the active ingredient in Xiaflex, or to one of the inactive ingredients in the drug. Make sure that your doctor knows your allergy history before proceeding.
If you have a health condition that promotes bleeding or bruising, share this information with your doctor before you undergo Xiaflex treatment. If you currently use blood-thinning medications such as NSAIDs or warfarin, you may need to stop taking these drugs (if possible) at least one week before undergoing Xiaflex treatment.
What Should You Expect From a Xiaflex Injection?
In this outpatient procedure, your plastic surgeon will inject the Xiaflex into a troublesome cord of tissue and then wrap the treated hand with gauze. You'll receive instructions to come back to the office within one to three days for a follow-up evaluation. You can safely receive up to three such injections, each one month apart.
Immediately following the injection, you'll want to keep the treated hand elevated and resist the urge to flex your fingers. After your follow-up exam, you'll receive a night splint to wear on your hand for up to four months. You'll also need to perform gentle exercises to regain the desired range of motion in your fingers.
Common side effects from Xiaflex injections include bruising, swelling, and discomfort at the treatment site. Some people may also develop swollen lymph nodes under the arm or at the elbow. While these side effects should pass without incident, inform your doctor if you develop an infection or experience nerve problems.
Whether you stand to gain by pursuing a Xiaflex injection or you might do better with surgery to address your Dupuytren's contracture, Ronald C. Barry, MD, can lend a helping hand.
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our plastic surgery center today to get all your questions answered and schedule a medical consultation.
