Additional Treatment after Collagenase Injections and Needle Fasciotomy for Dupuytren’s Disease: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Denise M. J. Arnold ◽  
Jonathan Lans ◽  
Ritsaart Westenberg ◽  
Kiera Lunn ◽  
Philip Blazar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Additional Treatment ◽  
Dupuytren’S Disease ◽  
Bivariate Analysis ◽  
Dupuytren's Disease ◽  
Bilateral Disease ◽  
Collagenase Injection ◽  
Partial Fasciectomy

Abstract Introduction The aim of this study was to assess the rate of additional treatment after collagenase injection and needle fasciotomy, and what factors are associated with additional procedures for recurrence. Materials and Methods We retrospectively identified 201 adult patients who underwent collagenase injection and 19 patients who underwent needle fasciotomy for Dupuytren’s disease from 2012 to 2014. Outcomes included additional treatment of the same ray for either recurrence or persistence of contracture. To evaluate associated factors, we performed a bivariate analysis. Results Additional treatment after collagenase injection for recurrence was performed in 24% of fingers at a median of 23 months (interquartile range [IQR]: 10.8–36.1) and was associated with bilateral disease (p = 0.008). Additional treatment for persistence was performed in 5.6% at a median of 1.9 months (IQR: 1.1–3.2). Additional treatment for recurrence after needle fasciotomy was performed in 13% of fingers at a median of 28.2 months (IQR: 27.5–28.2) and 4.2% for persistence at 1.1 months. Fingers treated with needle fasciotomy were more likely to undergo secondary open fasciectomy (13% vs. 5.1%, p = 0.022). Conclusion Additional treatment after collagenase injections was performed in 29% of fingers, mostly another collagenase injection, and was associated with bilateral disease. After needle fasciotomy, 17% of patients underwent additional treatment, primarily open partial fasciectomy.

Recurrent Dupuytren’s disease after fasciectomy and collagenase injection are histologically indistinguishable

2020 ◽  
Vol 45 (5) ◽  
pp. 508-512
Author(s):  
Rafael Sanjuan-Cervero ◽  
Francisco J. Carrera-Hueso ◽  
Manuel Vaquero-Perez ◽  
Daniel Montaner-Alonso
Keyword(s):  
Cohort Study ◽  
Prospective Cohort ◽  
Previous Treatment ◽  
Disease Recurrence ◽  
Dupuytren’S Disease ◽  
Collagenase Clostridium Histolyticum ◽  
Dupuytren's Disease ◽  
Clostridium Histolyticum ◽  
Collagenase Injection ◽  
Previously Treated

The aim of this study was to determine whether recurrent Dupuytren’s disease after collagenase Clostridium histolyticum treatment differs histologically from recurrence in those treated with fasciectomy. We carried out a prospective cohort study of patients with Dupuytren’s disease who underwent fasciectomy to treat disease recurrence after previous treatment with collagenase Clostridium histolyticum or fasciectomy. The pathologists and statistician were blinded to the previous treatment. Longitudinal biopsy sections were stained with haematoxylin-eosin and the nodular zones were examined. Fifteen patients were studied: nine previously treated with collagenase Clostridium histolyticum and six previously treated with fasciectomy. There were no histological differences between the samples from the two groups of patients. Dupuytren’s disease recurrences after fasciectomy and collagenase Clostridium histolyticum are histologically indistinguishable.

scholarly journals Segmental aponeurectomy with Z-Plasty as a treatment option in Dupuytren's disease: A retrospective cohort study

2019 ◽  
Vol 105 (8) ◽  
pp. 1627-1631
Author(s):  
Ludivine Gardeil ◽  
Valérie Matter Parrat ◽  
Anne Carole Portenard ◽  
Dorothée Coquerel ◽  
Albane Bonmarchand ◽  
...  
Keyword(s):  
Cohort Study ◽  
Treatment Option ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease

scholarly journals The trend of direct medical costs and associated factors in patients with chronic hepatitis B in Guangzhou, China: an eight-year retrospective cohort study

2021 ◽  
Vol 21 (S2) ◽  
Author(s):  
Shuo Yang ◽  
Ge Chen ◽  
Yueping Li ◽  
Guanhai Li ◽  
Yingfang Liang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis B ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Medical Insurance ◽  
Medical Costs ◽  
Direct Medical Costs ◽  
B Virus ◽  
The Cost

Abstract Background Although the expenses of liver cirrhosis are covered by a critical illness fund under the current health insurance program in China, the medical costs associated with hepatitis B virus (HBV) related diseases is not well addressed. In order to provide evidence to address the problem, we investigated the trend of direct medical costs and associated factors in patients with chronic HBV infection. Methods A retrospective cohort study of 65,175 outpatients and 12,649 inpatients was conducted using a hospital information system database for the period from 2008 to 2015. Generalized estimating equations (GEE) were applied to explore associations between annual direct medical costs and corresponding factors, meanwhile quantile regression models were used to evaluate the effect of treatment modes on different quantiles of annual direct medical costs stratified by medical insurances. Results The direct medical costs increased with time, but the proportion of antiviral costs decreased with CHB progression. Antiviral costs accounted 54.61% of total direct medical costs for outpatients, but only 6.17% for inpatients. Non-antiviral medicine costs (46.06%) and lab tests costs (23.63%) accounted for the majority of the cost for inpatients. The direct medical costs were positively associated with CHB progression and hospitalization days in inpatients. The direct medical costs were the highest in outpatients with medical insurance and in inpatients with free medical service, and treatment modes had different effects on the direct medical costs in patients with and without medical insurance. Conclusions CHB patients had a heavy economic burden in Guangzhou, China, which increased over time, which were influenced by payment mode and treatment mode.

Risk Factors of Early Childhood Caries in a Southeast Asian Population

2006 ◽  
Vol 85 (1) ◽  
pp. 85-88 ◽  
Author(s):  
W.H. van Palenstein Helderman ◽  
W. Soe ◽  
M.A. van ’t Hof
Keyword(s):  
Risk Factors ◽  
Early Childhood ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Associated Factors ◽  
Early Childhood Caries ◽  
Asian Population ◽  
Supplementary Food ◽  
Southeast Asian Population ◽  
Nocturnal Feeding

A retrospective cohort study on ECC and associated factors was conducted among mothers with 25- to 30-month-old infants in a community where prolonged breastfeeding was common practice. All infants who consumed sugary supplementary food or rice that was pre-chewed by the mother, or who fell asleep with the breast nipple in their mouths, had ECC. Infants without those habits, and who were breastfed up to 12 months, had no ECC. Breastfeeding during the day beyond the age of 12 months was not associated with ECC, but infants who were breastfed at night > 2 times had an OR for ECC of 35 (CI 6-186), and those who were exposed to > 15 min per nocturnal feeding had an OR for ECC of 100 (CI 10-995). The present study indicates that, in this population, besides the consumption of sugars and pre-chewed rice, nocturnal breastfeeding after the age of 12 months poses a risk of developing ECC.

Dupuytren’s disease

2011 ◽  
Author(s):  
Peter Burge
Keyword(s):  
Surgical Treatment ◽  
Steroid Injection ◽  
Treatment Options ◽  
Genetic Component ◽  
Dupuytren’S Disease ◽  
Palmar Fascia ◽  
Dupuytren's Disease ◽  
Collagenase Injection ◽  
Operative Complications ◽  
Non Surgical Treatment

♦ Dupuytren’s disease is characterised by contracture of a finger resulting from thickening and shortening of the palmar fascia♦ A genetic component to the aetiology is apparent, smoking, alcohol and diabetes can increase the risk♦ The pathogenesis of Dupuytren’s disease remains elusive♦ Non-surgical treatment options include splintage, steroid injection and collagenase injection♦ Surgery cannot cure the disease but can straighten bent digits and minimize recurrence♦ Operative methods can be considered with regards to incision, management of the diseased fascia and closure techniques♦ Operative complications include injury of digital nerves and arteries

The influence of skin tears following collagenase treatment of Dupuytren’s disease on treatment outcomes

2020 ◽  
pp. 175319342094132
Author(s):  
Robert Phan ◽  
Warren M. Rozen ◽  
Giselle Dela Cruz ◽  
Vicky Tobin ◽  
David J. Hunter-Smith
Keyword(s):  
Patient Reported Outcomes ◽  
Dupuytren’S Disease ◽  
Extension Deficit ◽  
Level Of Evidence ◽  
Dupuytren's Disease ◽  
Finger Extension ◽  
Patient Reported ◽  
Collagenase Injection ◽  
Skin Tears ◽  
Pre Treatment

This study investigated influence of skin tears on patient-reported outcomes of injection of collagenase clostridium histolyticum for Dupuytren’s disease and association between extension deficit of digits before injection and skin tear after the injection. From 2016 to 2018, 391 Dupuytren’s cords were treated in 184 patients in a prospective cohort study and the patients were evaluated before injection and six months after injection. Skin tears occurred in 50% of these patients. We found no significant differences in the patient-reported outcomes between patients with or without skin tears. A higher extension deficit before treatment was associated with significantly increased frequency of skin tears. We conclude that the incidence of skin tears after injection does not affect patient reported outcomes six months after collagenase injection, but the incidence of skin tears is significantly associated with the severity of pre-treatment finger extension deficits. Level of evidence: II

scholarly journals Serious complications and risk of re-operation after Dupuytren’s disease surgery: a population-based cohort study of 121,488 patients in England

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Osaid Alser ◽  
Richard S. Craig ◽  
Jennifer C. E. Lane ◽  
Albert Prats-Uribe ◽  
Danielle E. Robinson ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Case Series ◽  
Population Based ◽  
Dupuytren’S Disease ◽  
Dupuytren's Disease ◽  
Systemic Complications ◽  
Increased Risk ◽  
Risk Patients ◽  
Limited Fasciectomy

Abstract Dupuytren’s disease (DD) is a common fibro-proliferative disorder of the palm. We estimated the risk of serious local and systemic complications and re-operation after DD surgery. We queried England’s Hospital Episode Statistics database and included all adult DD patients who were surgically treated. A longitudinal cohort study and self-controlled case series were conducted. Between 1 April 2007 and 31 March 2017, 121,488 adults underwent 158,119 operations for DD. The cumulative incidence of 90-day serious local complications was low at 1.2% (95% CI 1.1–1.2). However, the amputation rate for re-operation by limited fasciectomy following dermofasciectomy was 8%. 90-day systemic complications were also uncommon at 0.78% (95% CI 0.74–0.83), however operations routinely performed under general or regional anaesthesia carried an increased risk of serious systemic complications such as myocardial infarction. Re-operation was lower than previous reports (33.7% for percutaneous needle fasciotomy, 19.5% for limited fasciectomy, and 18.2% for dermofasciectomy). Overall, DD surgery performed in England was safe; however, re-operation by after dermofasciectomy carries a high risk of amputation. Furthermore, whilst serious systemic complications were unusual, the data suggest that high-risk patients should undergo treatment under local anaesthesia. These data will inform better shared decision-making regarding this common condition.

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