Southampton hospital leads the way on hand condition treatment

Southampton NHS Treatment Centre is the biggest adopter in the region of a non-invasive alternative to a surgical procedure which may be phased out by the NHS 
Dupuytren’s contracture is debilitating and affects two million in the UK
Xiapex, the non-surgical alternative, is popular with patients and has a recovery time of about two weeks, compared with 8 to 12 weeks in surgical cases
In the region, Southampton NHS Treatment Centre is the biggest adopter of a drug called Xiapex, which is used to treat Dupuytren’s contracture. Dupuytren’s contracture is a condition which affects the hands and fingers and happens when the connective tissue changes in the hand, and becomes enlarged and stiff. Over time this can cause one or more fingers to bend towards the palm, and the connective tissues in the palm to stiffen and cause a cord-like a rope in the palm. Around two million people in the UK are affected by the condition.
The usual treatment is surgery, which involves different techniques. This involves a surgeon making a cut along the palm and finger and manually removing the Dupuytren’s tissue (all or a part of it) and straightening the affected digit. This surgical procedure is one of 17 routine treatments which may be withdrawn from the NHS over the next 18 months, following discussion and consultation.
The alternative is the use of a drug called Xiapex, and Southampton NHS Treatment Centre has administered this treatment more than any other hospital in the region – 90 injections given to patients in the hospital’s Outpatient Department over the past year. Xiapex is injected directly into the cord of connective tissue, dissolving it and allowing a doctor to manually straighten the affected digits.
The injection does not need general or regional anaesthetic, but a local anaesthetic is applied for the manipulation.
Mr Vasileios Kefalas and Mr Petros Mikalef, Consultant Hand Surgeons at Southampton NHS Treatment Centre who administer Xiapex and carry out the ensuing manipulation, commented: “Treating Dupuytren’s contracture with Xiapex is effective, with 92% of patients in the UK who have had the procedure saying they were ‘very satisfied’ or ‘quite satisfied’ with the results. There are advantages over the invasive surgery option. The most a patient will need is a local anaesthetic (surgery can often require a general anaesthetic or regional block) which means patients can go home on the day of treatment, which takes place in an outpatient room. Recovery times are also faster – for surgery recovery can take from 4 to 8-12 weeks, yet with Xiapex a patient has usually recovered within a fortnight.”
While treatment with Xiapex is effective it may not be right for everyone – at Southampton NHS Treatment Centre a Consultant Hand Surgeon will assess a patient’s needs and discuss treatment options with them.
Southampton NHS Treatment Centre offers a wide range of planned, elective surgery and treatment including orthopaedics (such as hip and knee replacements) including a dedicated Hand Surgery service, eye surgery (such as cataract removal), general surgery (such as hernia repair and gall bladder removal), ENT, oral surgery, gynaecology, urology, pain management and X-ray and ultrasound.
The hospital is part of the choice patients can make about where they receive their NHS treatment. If their GP (or optician for cataract surgery or dentist for oral surgery) agrees that they need treatment and it is for a procedure carried out at Southampton NHS Treatment Centre, patients can ask to be referred there for their care.
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7 things you need to know about Dupuytren’s contracture
It mainly affects the ring and little fingers
You can have it in both hands at the same time
It gets slowly worse over time
It affects two million people in the UK
It begins with lumps or ridges on your palms
Eventually your fingers bend in towards the palm
It can affect other parts of your body in its more aggressive types
You should see your GP if it is getting in the way of daily activities