The Plastic Surgeon’s Approach toRaynaud’s Syndrome: An Update

Sophia OpelPlastic Surgery Registrar

Royal Free Hospital

Why is this important to us?

• Common– 10 million people in the UK

• Numerous causes– Including scleroderma

• Spasm of blood supply to fingers! pain,numbness, ulcers, gangrene, REDUCEDHAND FUNCTION

Why here?

• Royal Free Hospital is recognised as a majorEuropean centre for the treatment ofscleroderma

• Current management for Raynaud’s:– Avoidance of cold, nicotine, caffeine– If severe: intravenous iloprost (infusion

5-10 days) BUT WHAT IS NEW?

Botox!

Botox

Botox in Raynaud’s Syndrome

• NICE approved treatment• Led by Professor Butler• Injections into base of fingers• Thermographic camera• Before and after:

– Pain score– Activity of daily living score– Hand function assessment

Findings• 20 patients with scleroderma• 80% overall improvement in symptoms ☺ • 80% reduction in pain• 75% improved appearance• 65% improved cold intolerance• 90% improved pinch• 80% improvement in daily activity score

Side Effects?

• Small amount of muscle weakness– (2 patients, all improved within 6 weeks and hand

function was still improved)

How does it work?

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Get involved!• Please leave your contact details • Or, discuss with your medical team

Thank you