Download PDF
CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2019; 47(02): 105-114
DOI: 10.1055/s-0039-3399514
Original Article | Artículo Original
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Tratamiento de la Enfermedad de Dupuytren en España

Dupuytren Disease Treatment in Spain
Rafael Sanjuan Cerveró
1   Servicio de Cirugía Ortopédica y Traumatología, Hospital de Denia, Alicante, Spain
,
Diego Gómez Herrero
2   Servicio de Farmacia, Vithas Hospital 9 de Octubre, Valencia, Spain
3   Programa de Doctorado en Farmacia, Universidad de Granada, Granada, Spain
,
Carlos Novoa Parra
1   Servicio de Cirugía Ortopédica y Traumatología, Hospital de Denia, Alicante, Spain
,
Fernando Peña Molina
1   Servicio de Cirugía Ortopédica y Traumatología, Hospital de Denia, Alicante, Spain
,
Nuria Franco Ferrando
1   Servicio de Cirugía Ortopédica y Traumatología, Hospital de Denia, Alicante, Spain
› Author Affiliations
Further Information

Publication History

15 September 2019

24 September 2019

Publication Date:
19 November 2019 (online)

   Permissions and Reprints

Resumen

Objetivos Nuestro objetivo consiste en valorar la situación actual en España del tratamiento de la enfermedad de Dupuytren mediante una encuesta realizada a los cirujanos de mano españoles y compararla con una encuesta similar realizada en España antes de la comercialización de la colagenasa en Europa.

Material y Métodos Se remite una encuesta a los socios de la Sociedad Española de Cirugía de la Mano (SECMA) con 30 preguntas divididas en 4 bloques: aspectos demográficos, opinión general del tratamiento de la enfermedad de Dupuytren, casos clínicos y repercusión de la introducción de la colagenasa Clostridium Histolyticum en el tratamiento.

Resultados La tasa de respuesta fue del 38,2% sobre un total de 332 socios. La mayor parte de los participantes se consideró como cirujanos no noveles. La fasciectomía parcial es la técnica más frecuentemente utilizada (73% de los encuestados) y considerada de primera elección (61,9%) seguida por la colagenasa (23% y 31% respectivamente). Más de la mitad de los encuestados consideró que ha habido un cambio en el modo de afrontar la enfermedad de Dupuytren en los últimos 5 años. Con respecto a la colagenasa, actualmente el uso de los protocolos iniciales se ha abandonado, aunque el protocolo de tratamiento más habitual sigue siendo la administración de una dosis desechando el resto del vial.

Conclusiones Actualmente la fasciectomía parcial es la técnica preferida y más frecuentemente utilizada en la enfermedad de Dupuytren seguida de la colagenasa en España.

Abstract

Objectives Our objective is to assess the current situation in Spain of Dupuytren’s disease treatment through a survey of Spanish hand surgeons and compare it with a similar survey conducted in Spain before the commercialization of collagenase in Europe.

Methods A survey was sent to the members of the Spanish Society of Hand Surgery (SECMA) with 30 questions divided into four blocks: demographics, general opinion of Dupuytren’s disease treatment, clinical reports and impact of the introduction of collagenase Clostridium Histolyticum as treatment for this pathology.

Results The response rate was 38.2% over a total of 332 members. The major part of the participants were considered as non-novel surgeons. Partial fasciectomy is the most frequently used technique (73% of respondents) and considered first choice treatment (61.9%) followed by collagenase (23% and 31% respectively). More than half of the respondents considered that there has been a change in how to deal with Dupuytren’s disease in the last 5 years. With regarding collagenase, currently the use of the initial protocols has been abandoned, although the most common treatment protocol remains the administration of a dose discarding the rest of the bottle.

Conclusions Currently, partial fasciectomy is the preferred technique and more frequently used in Dupuytren’s disease followed by collagenase in Spain.

Palabras clave

enfermedad de Dupuytren - fasciectomía - colagenasa - encuesta

Keywords

Dupuytren’s disease - fasciectomy - collagenase - survey

Supplementary Material

 

  • Bibliografía

  • 1 Hueston J. Lessons in Dupuytren's disease. Ann Chir Main Memb Super 1992; 11 (05) 349-354 . Doi:10.1016/S0753-9053(05)80269-8
    PubMedGoogle Scholar
  • 2 Hurst LC, Badalamente MA, Hentz VR. , et al; CORD I Study Group. Injectable collagenase clostridium histolyticum for Dupuytren's contracture. N Engl J Med 2009; 361 (10) 968-979 . Doi:10.1056/NEJMoa0810866
    CrossrefPubMedGoogle Scholar
  • 3 Sanjuan-Cerveró R, Vazquez-Ferreiro P, Gomez-Herrero D, Carrera-Hueso FJ. Efficacy of Collagenase Clostridium Histolyticum for Dupuytren Disease: A Systematic Review. Rev Iberoam Cir Mano 2017; 45 (02) 70-88
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Muñoz-Peñin R, Lwoff N, Renú JMA. Enfermedad de Dupuytren, una vista panorámica de nuestro entorno. Rev Iberoam Cir Mano 2011; 39 (02) 126-134 . Doi:10.1055/s-0037-1606801
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Naam NH. Functional outcome of collagenase injections compared with fasciectomy in treatment of Dupuytren's contracture. Hand (N Y) 2013; 8 (04) 410-416 . Doi:10.1007/s11552-013-9540-7
    CrossrefPubMedGoogle Scholar
  • 6 Sanjuan-Cerveró R, Carrera-Hueso FJ, Vazquez-Ferreiro P, Gomez-Herrero D. Adverse Effects of Collagenase in the Treatment of Dupuytren Disease: A Systematic Review. BioDrugs 2017; 31 (02) 105-115 . Doi:10.1007/s40259-017-0211-z
    CrossrefPubMedGoogle Scholar
  • 7 Chen NC, Shauver MJ, Chung KC. Cost-effectiveness of open partial fasciectomy, needle aponeurotomy, and collagenase injection for dupuytren contracture. J Hand Surg Am 2011; 36 (11) 1826-1834.e32 . Doi:10.1016/j.jhsa.2011.08.004
    CrossrefPubMedGoogle Scholar
  • 8 Mehta S, Belcher HJCR. A single-centre cost comparison analysis of collagenase injection versus surgical fasciectomy for Dupuytren's contracture of the hand. J Plast Reconstr Aesthet Surg 2014; 67 (03) 368-372 . Doi:10.1016/j.bjps.2013.12.030
    CrossrefPubMedGoogle Scholar
  • 9 Sanjuan Cerveró R, Franco Ferrando N, Poquet Jornet J. Use of resources and costs associated with the treatment of Dupuytren's contracture at an orthopedics and traumatology surgery department in Denia (Spain): collagenase clostridium hystolyticum versus subtotal fasciectomy. BMC Musculoskelet Disord 2013; 14 (01) 293 . DOI: 10.1186/1471-2474-14-293
    CrossrefPubMedGoogle Scholar
  • 10 Warwick D. Collagenase: What We May Never Know (A Discussion). In: Werker PMN, Dias J, Eaton C, Reichert B, Wach W. , eds. Dupuytren Disease and Related Diseases - The Cutting Edge. Springer International Publishing; 2017: 145-149 . doi:10.1007/978-3-319-32199-8_19
    CrossrefGoogle Scholar
  • 11 Jupiter J, Burke D. Scott's parabola and the rise of the medical-industrial complex. Hand (N Y) 2013; 8 (03) 249-252 . Doi:10.1007/s11552-013-9526-5
    CrossrefPubMedGoogle Scholar
  • 12 Scott JW. Scott's parabola. BMJ 2001; 323 (7327): 1477 . DOI: 10.1136/bmj.323.7327.1477
    CrossrefPubMedGoogle Scholar
  • 13 Lipman MD, Carstensen SE, Deal DN. Trends in the Treatment of Dupuytren Disease in the United States Between 2007 and 2014. Hand (N Y) 2017; 12 (01) 13-20 . Doi:10.1177/1558944716647101
    CrossrefPubMedGoogle Scholar
  • 14 Thayer MK, Somerson JS, Huang JI. Changes in Provider Treatment Patterns for Dupuytren's Contracture: Analysis of Trends in Medicare Beneficiaries. Plast Reconstr Surg Glob Open 2018; 6 (10) e1932 . DOI: 10.1097/GOX.0000000000001932
    CrossrefPubMedGoogle Scholar
  • 15 Zhao JZ, Hadley S, Floyd E, Earp BE, Blazar PE. The Impact of Collagenase Clostridium histolyticum Introduction on Dupuytren Treatment Patterns in the United States. J Hand Surg Am 2016; 41 (10) 963-968 . Doi:10.1016/j.jhsa.2016.07.090
    CrossrefPubMedGoogle Scholar
  • 16 Crean SM, Gerber RA, Le Graverand MP, Boyd DM, Cappelleri JC. The efficacy and safety of fasciectomy and fasciotomy for Dupuytren's contracture in European patients: a structured review of published studies. J Hand Surg Eur Vol 2011; 36 (05) 396-407 . Doi:10.1177/1753193410397971
    CrossrefPubMedGoogle Scholar
  • 17 Sennwald GR. Fasciectomy for treatment of Dupuytren's disease and early complications. J Hand Surg Am 1990; 15 (05) 755-761
    CrossrefPubMedGoogle Scholar
  • 18 Lesiak AC, Jarrett NJ, Imbriglia JE. Modified McCash Technique for Management of Dupuytren Contracture. J Hand Surg Am 2017; 42 (05) 395.e1-395.e5 . Doi:10.1016/j.jhsa.2017.01.018
    CrossrefPubMedGoogle Scholar
  • 19 Arandes-Renú JM, Sanjuán-Cerveró R, Moya-Molinas I. Collagenase in Europe from the Experimental Phase to Practical Use. In: Pajardi G, Badalamente MA, Hurst LC. , eds. Collagenase in Dupuytren Disease. Cham: Springer International Publishing; 2018: 39-74 . doi:10.1007/978-3-319-65822-3_4
    CrossrefGoogle Scholar
  • 20 Eaton C. Dupuytren and Rare Disease Research. Dupuytren Research Group. https://dupuytrens.org/dupuytren-and-rare-disease-research/ . Published July 1, 2019. Accessed July 30, 2019.
    PubMedGoogle Scholar
  • 21 Reichert B, Baringer M. [Preferred treatment options of German hand surgeons in Dupuytren disease]. Handchir Mikrochir Plast Chir 2018; 50 (03) 196-201 . Doi:10.1055/a-0645-7075
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Marks M, Krefter C, Herren DB. [Treatment Methods for Patients with Dupuytren's Disease in Switzerland]. Handchir Mikrochir Plast Chir 2016; 48 (03) 155-160 . Doi:10.1055/s-0042-104056
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Carr L, Michelotti B, Brgoch M, Hauck R, Ingraham J. Dupuytren Disease Management Trends: A Survey of Hand Surgeons. Hand (N Y) 2018; 1558944718787281 (July): 1558944718787281 . DOI: 10.1177/1558944718787281
    PubMedGoogle Scholar
  • 24 McMillan C, Yeung C, Binhammer P. Variation in Treatment Recommendations for Dupuytren Disease. J Hand Surg Am 2017; 42 (12) 963-970.e6 . Doi:10.1016/j.jhsa.2017.08.023
    CrossrefPubMedGoogle Scholar
  • 25 Bainbridge C, Dahlin LB, Szczypa PP, Cappelleri JC, Guérin D, Gerber RA. Current trends in the surgical management of Dupuytren's disease in Europe: an analysis of patient charts. Eur Orthop Traumatol 2012; 3 (01) 31-41 . Doi:10.1007/s12570-012-0092-z
    CrossrefPubMedGoogle Scholar
  • 26 Dahlin LB, Bainbridge C, Leclercq C. , et al. Dupuytren's disease presentation, referral pathways and resource utilisation in Europe: regional analysis of a surgeon survey and patient chart review. Int J Clin Pract 2013; 67 (03) 261-270 . Doi:10.1111/ijcp.12099
    CrossrefPubMedGoogle Scholar
  • 27 Dias J, Bainbridge C, Leclercq C. , et al. Surgical management of Dupuytren's contracture in Europe: regional analysis of a surgeon survey and patient chart review. Int J Clin Pract 2013; 67 (03) 271-281 . Doi:10.1111/ijcp.12106
    CrossrefPubMedGoogle Scholar
  • 28 Moermans JP. Segmental aponeurectomy in Dupuytren's disease. J Hand Surg [Br] 1991; 16 (03) 243-254 . Doi:10.1016/0266-7681(91)90047-R
    CrossrefPubMedGoogle Scholar
  • 29 Gilpin D, Coleman S, Hall S, Houston A, Karrasch J, Jones N. Injectable collagenase Clostridium histolyticum: a new nonsurgical treatment for Dupuytren's disease. J Hand Surg Am 2010; 35 (12) 2027-38.e1 . Doi:10.1016/j.jhsa.2010.08.007
    CrossrefPubMedGoogle Scholar