[Long-term experience with Collagenase Clostridium Histolyticum (CCH, Xiapex®) for the treatment of Dupuytren's contracture: lessons learned].

Introduction CCH (Collagenase Clostridium Histolyticum; Xiapex ((R)) ) has become established as a simple and reliable alternative to traditional treatments for Dupuytren's contracture. This study aims to analyse our results and discuss our modifications of this therapy. Patients and methods The study included 312 fingers treated with CCH between 2011 and 2018 (256 patients; 225 men and 31 women). There were 157 fingers (50.3 %) with an isolated joint contracture, while multiple joints were affected in 155 fingers (49.7 %). The average age at surgery was 65.8 years. The follow-up period averaged 41.2 weeks. A retrospective data analysis evaluated our results and the effect of our technical modifications on treatment success. Results The average presurgical degree of contracture was 63.3 degrees. The average contracture reduction compared to the initial value was 94 % immediately after surgery and 81 % at the last follow-up. There were skin cracks in 22.1 %. The postsurgical course was uneventful in 99.4 %, with minor complications in 0.6 %. The recurrence rate was 14.4 % Extension of the time interval until stretching (24 vs. 48 hours) had no significant effect on the immediate success rate or the rate of skin lesions. Conclusions If the indication is chosen correctly and the treatment is performed by an experienced surgeon, the success rate with CCH is comparable to other current treatment options