Hypnotherapy in the treatment of Dupuytren's disease with collagenase: our center's experience beyond the guidelines

BACKGROUND: The use of Collagenase Clostridium Histolyticum for Dupuytren's Disease has spread progressivelysince its introduction into clinical practice. This diffusion has also led to a progressive widening of what the original indications were. This article aims to share our experience to improve our patient's quality of care and treatment outcomes. METHODS: In our Hospital, some changes were made to the original FDA guidelines. We treated not a single cord at one time but multiple joints on several digital rays simultaneously. Furthermore, in patients with severe PIPJ contracture, we used a two-stage approach: the first stage was the injection, and the second stage was a volar open capsulotomy. A further innovation introduced was pain control by hypnotic induction. RESULTS: This approach shortened the treatment of patients who would have had multiple procedures and simplified surgery in more complex cases. The hypnotherapy associated with the treatment allowed good pain control and reduced the use of analgesics. CONCLUSIONS: Pushing the boundaries beyond conventional guidelines can be a safe approach to improve the quality of care and outcomes for patients with Dupuytren's disease.