title: Collagenase Clostridium histolyticum: emerging practice patterns and treatment advances.
abstract: OBJECTIVE
  This study aims to provide a comprehensive review of the role of Collagenase Clostridium histolyticum (CCH).
  
  
  METHODS
  This review is based on a literature review and practical experience.
  
  
  RESULTS
  This review provides practical management strategies for using collagenase by sharing clinical experiences over the past few years; logistical aspects of in-clinic treatment, lessons learned, and novel approaches to correct traditionally hard-to-treat contractures are discussed. In addition a brief, yet comprehensive overview is provided on the pathophysiology of the disease, the mechanism of collagenase action and results of clinical studies.
  
  
  CONCLUSIONS
  CCH has an evolving role as one of the tools available for treating Dupuytren's disease.
authors.affiliation: a The Hand Clinic, University Hospital Southampton , Hampshire , UK ;
authors.forename: David
authors.initials: D
authors.lastname: Warwick
authors.affiliation: b Servicio de Cirugía Ortopédica y Traumatología, Unidad de Mano , Hospital Clínic , Barcelona , Spain , Universidad de Barcelona ;
authors.forename: José M
authors.initials: JM
authors.lastname: Arandes-Renú
authors.affiliation: c Department of Hand Surgery , San Giuseppe MultiMedica University Hospital, Milan and Università degli Studi di , Milano , Italy ;
authors.forename: Giorgio
authors.initials: G
authors.lastname: Pajardi
authors.affiliation: d Hand Surgery, Schön Klinik Vogtareuth , Vogtareuth , Germany ;
authors.forename: Jörg
authors.initials: J
authors.lastname: Witthaut
authors.affiliation: e Department of Orthopaedics , Stony Brook School of Medicine , Stony Brook , NY , USA.
authors.forename: Lawrence C
authors.initials: LC
authors.lastname: Hurst
mesh_terms: D002986:Clinical Trials as Topic; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D004387:Dupuytren Contracture / Q000188:drug therapy*; D005081:Exercise Therapy; D006801:Humans; D015552:Injections, Intralesional; D003012:Microbial Collagenase / Q000627:therapeutic use*; D012008:Recurrence; D013165:Splints
chemical_list: D003012:Microbial Collagenase
keywords: Clostridium histolyticum; clinical practice; clinical trial; collagenase; dupuytren’s disease; xiaflex; xiapex