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Dr. Ed, question about hyaluronidase (Wydase)

Posted by Matt L on 12/13/01 at 09:49 (066873)

In a prior post (in August) you mentioned hyaluronidase (Wydase) as an injected medicine beneficial in the breakdown of scar tissue that may be entrapping a nerve. I have recurrent TTS. My doctor has injected cortisone (with very minimal results). However, he quickly dismissed hyaluronidase (Wydase) as something he 'didn't think was being used anymore' (because of ineffectiveness?). Is there any information out there that may support the effectiveness of hyaluronidase (Wydase) for TTS that I might direct my doctor to? Is there any controversy regarding this medicine?

Re: Dr. Ed, question about hyaluronidase (Wydase)

Dr. Zuckerman on 12/13/01 at 10:48 (066876)

I know this is for Dr. Ed but he he Dr. Z opinion. Wydase is very effective for scar tissue areas. Now injecting it into the Tarsal tunnel is something I have never done so Dr. Ed will have to give his experience about injecting this into the TTS area. IF I have any additional literature will pass it on to you but nothing at this time.

Re: Dr. Ed, question about hyaluronidase (Wydase)

Ed Davis, DPM on 12/13/01 at 23:54 (066930)

Wydase is in very widespread use. It is used paritcularly heavily by plastic and cosmetic surgeons to cut down on scar tissue.

I tend to favor a mixture of 'cortisone' and Wydase in many cases. The term 'cortisone' actually refers to a category of substances, some of which would have minimal effect on scar tissue and some with dramtic effects. I did a post a while back in which I described the vaarious forms of 'cortisone' and how they work. I am still hoping that Scott can incorporate that information into his website somehow as I feel that an understanding of this is important.

Ask you doctor specifically what the name of the 'cortisone' he has used---it could help in explaining its effect or lack of. The type of cortisone that would be most effective in the scenario you present include triamcinolone acetonide (Kenalog is a popular trade name) and to a lessor extent, Depo-Medrol.
Ed

Re: Dr. Ed, question about hyaluronidase (Wydase)

Dr. Zuckerman on 12/13/01 at 10:48 (066876)

I know this is for Dr. Ed but he he Dr. Z opinion. Wydase is very effective for scar tissue areas. Now injecting it into the Tarsal tunnel is something I have never done so Dr. Ed will have to give his experience about injecting this into the TTS area. IF I have any additional literature will pass it on to you but nothing at this time.

Re: Dr. Ed, question about hyaluronidase (Wydase)

Ed Davis, DPM on 12/13/01 at 23:54 (066930)

Wydase is in very widespread use. It is used paritcularly heavily by plastic and cosmetic surgeons to cut down on scar tissue.

I tend to favor a mixture of 'cortisone' and Wydase in many cases. The term 'cortisone' actually refers to a category of substances, some of which would have minimal effect on scar tissue and some with dramtic effects. I did a post a while back in which I described the vaarious forms of 'cortisone' and how they work. I am still hoping that Scott can incorporate that information into his website somehow as I feel that an understanding of this is important.

Ask you doctor specifically what the name of the 'cortisone' he has used---it could help in explaining its effect or lack of. The type of cortisone that would be most effective in the scenario you present include triamcinolone acetonide (Kenalog is a popular trade name) and to a lessor extent, Depo-Medrol.
Ed