Skin grafts replaces thick,skin with thin skin taken from under your arm.Its like trading cardboard thick skin for paper thin skin.There is one of our regulars who has had like 20 grafts,it all depends on how agressive your dups are.If you have a nasty,case it does not matter what u do.Its comin back worse,every time you mess with it.It will show up in your feet too,if you mess with it enough.Just sayin.Dave

Edited 06/17/12 05:58

Hi Tusk
I've had 4 grafts with the donor area being from the top of the leg- groin area . The grafts were considered after reapeat surgery and were not the first option . Grafting on the inside of the hand is not always successfull or easy. You would not want to have any sign of diabetes to hinder the recovery. One of my grafts covers the face of the ring and little finger.Recover is a long road . I have not had any sign of recorrence under the grafts but have had recorrence in other areas. When I was diagnosed 40 odd years ago NA. was not heard of. There are many factors to consider these days and age is one. Regards

Edited 06/17/12 12:37

No reason to be nervous, all will work out well. The good news is that recurrence slows down as we are getting older. You have a fair chance that your results will be stable for several years, with a little bit of luck even 5 years. And the injection can be repeated.

It would be interesting to know where your doctor got the information that "NA for persons with high reoccurence rates does not last as long as Xiaflex". There aren't any studies available comparing those two treatments. These studies are just getting started and will take several years before they can provide useful results. Maybe he got it from a Xiaflex sales person ...

Wolfgang

cglasgow:

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I am a bit nervous, but hopeful this will help. Just hope it helps for a while. My doctor said reoccurrence rates are higher if you have more than one related disease or more than one affected hand. He also said that NA for person's with high reoccurence rates does not last as long as Xiaflex. I'll post again after my procedure...

I am going in on Monday (10-08-12) for the injection with Dr Verheyden in Bend who has done close to 200 of these with almost 100% success rate. I've talked to several of his patients who responded to a newspaper article about the fact the I was retiring from music due to Dupuytrens. I feel now like I will have a new lease on my musical life.

Dr Verheyden has modified the manufacturer's recommendation - he injects into multiple locations in the contracture, and waits for the injection to work a bit - then injects some more. So his success rate is quite a bit higher than most, I would guess, because of this. My guess is that the reoccurrence rate will be less than surgery as well. Surgery seems to actually aggravate the condition in my experience (3 surgeries). I've talked with people that have had good results with NA - but the reoccurrence rate seems high. And it makes sense - it's not really getting rid of any material - it's just breaking it up a bit in one area. With Dr Verheyden's technique the enzyme is dissolving the cord in multiple places - so not as fertile ground for reoccurrence. Also the injection is way less invasive (no scar tissue etc). Also NA and surgery have the opportunity to damage the nerve, which happened to me during my last surgery. The Xiaflex procedure has a lot less risk for this. You can Google his name and the drug and find his pamphlet and a newspaper article about him.

Anyway I will post at the end of the week with my experience.

The left hand pinkie has had previous surgery and is now contracted about 90 deg. The index finger has a large nodule in the upper palm which is starting to develop contractures going up and down. So he will inject into both. Day before yesterday I noticed I'm getting one in my right hand - for the first time. I started getting these when I was 35 - I'm 64 now.

My advice - get someone who has done a lot of these and has a high success rate. Here in Eugene there are a couple of docs that do them - but they've only performed a handful each. The doc in Bend, OR has done quite a few and has adapted the technique - apparently his work is being closely followed in the industry as it may become the new 'best practice'.