Acta Chir Plast. 2020 Winter;62(3-4):64-67.
A non-surgical procedure for the treatment of Dupuytrens disease is a palmar injection of Collagenase Clostridium Histolyticum to the recommended depth of “around 2-3 mm”. However, there is little supporting evidence from the literature to substantiate this. The aim of this study was to evaluate the “optimal depth” for injection of Collagenase Clostridium Histolyticum by ultrasonography for the treatment of Dupuytrens disease.
A total of 43 patients were enrolled in this study. We marked the collagenase injection point on the skin above the cord before injection. We then measured the distance from the surface of the skin to the middle of the cord by ultrasonography long axis imaging and defined this as the “optimal depth”.
The average depth from the skin to the centre of the cord was 2.4 mm. The average distance from the surface of the skin to the proximal surface of the cord was 1.0 mm and the average thickness of the cord was 2.7 mm.
By precise measurement of individual cases utilising ultrasonography we were able to confirm that the recommendations for injection depth as provided by the supplier of Collagenase Clostridium Histolyticum (2-3 mm) were in agreement with our findings. However no objective guide was supplied as with regards to interindividual variability between patients and we suggest that the use of preliminary ultrasonography will likely provide improved outcomes.
一种治疗杜普伊特伦挛缩症的非手术方法是向推荐的“约 2-3 毫米”深度的掌部注射胶原酶溶组织梭菌。然而，文献中几乎没有支持这一观点的证据。本研究旨在通过超声评估胶原酶溶组织梭菌注射的“最佳深度”，以治疗杜普伊特伦挛缩症。
共有 43 例患者纳入本研究。我们在注射前在索状结构上方的皮肤上标记胶原酶注射点。然后，我们通过超声长轴成像测量从皮肤表面到索状结构中间的距离，并将其定义为“最佳深度”。
皮肤到索状结构中心的平均深度为 2.4 毫米。皮肤表面到索状结构近端表面的平均距离为 1.0 毫米，索状结构的平均厚度为 2.7 毫米。
通过对个体病例进行精确的超声测量，我们能够证实胶原酶溶组织梭菌供应商提供的注射深度建议（2-3 毫米）与我们的发现一致。然而，对于患者之间的个体差异，并没有提供客观的指导，我们建议使用初步的超声检查可能会提供更好的效果。
