Are Xiaflex injections for Dupuytren’s contracture really a non-surgical procedure?

Xiaflex injections are promoted by the drug manufacturer as a “non-surgical option for Dupuytren contracture treatment.”

I believe that is not an accurate statement. Xiaflex injections for Dupuytren’s contracture are more surgery than injection because:

  1. Xiaflex injections are a multi-step procedure performed in a particular way at particular locations to deliver a collagen-dissolving enzyme into a Dupuytren’s contracture fibrous cord;
  2. Special training to perform this procedure is required beyond what an untrained doctor – who already knows how to give injections – is expected to know;
  3. A standard medical release must be signed before a Xiaflex procedure is done;
  4. Blood loss can and does occur because the skin is penetrated to alter and remove unhealthy and abnormal tissue;
  5. Xiaflex injections often takes place in the operating room of a hospital, and when they are done in an office they are done following the same sterile technique that is used in surgery;
  6. A doctor is the only one who can perform a Xiaflex procedure;
  7. A nurse often assists during a Xiaflex procedure;
  8. Sterile gloves and surgical masks are worn;
  9. The hand is draped and made sterile prior to the procedure, and kept that way, just as in any surgery;
  10. A thoughtful doctor precedes the Xiaflex injections with a shot of numbing agent because the Xiaflex procedure can be prolonged and extremely painful;
  11. A careful doctor can take anywhere from 10-20 minutes to do a Xiaflex injection procedure;
  12. Insurance companies are billed anywhere from $1,000 to $4,000 just for the doctor to do the Xiaflex procedure. That is a lot of money for giving an injection.

Sounds like surgery, doesn’t it?

Xiaflex injections are only called a non-surgical procedure to minimize or eliminate patient resistance to the procedure.