Wound Healing with Medications for Rheumatoid Arthritis in Hand Surgery
Open Access
- 3 December 2012
- journal article
- Published by Hindawi Limited in ISRN Rheumatology
- Vol. 2012, 1-5
- https://doi.org/10.5402/2012/251962
Abstract
Introduction. Medications used to treat rheumatoid arthritis, such as corticosteroids, disease-modifying agents (DMARDs), and injectable biological agents (anti-TNFα), may have widespread effects on wound healing. In hand surgery, it is important to balance the risks of poor wound healing from continuing a medication against the risks of a flare of rheumatoid arthritis if a drug is temporarily discontinued.Materials and Methods. A United Kingdom (UK) group of 28 patients had metacarpophalangeal joint replacement surgery in 35 hands (140 wounds). All medication for rheumatoid arthritis was continued perioperatively, except for the injectable biological agents.Results. There were no instances of wound dehiscence or deep infection and only one episode of minor superficial infection.Conclusions. We conclude that provided care is taken to identify and treat any problems promptly, it is appropriate to continue most antirheumatoid medications in the perioperative period during hand surgery to reduce the risk of destabilising the patients' overall rheumatoid disease control.Keywords
Funding Information
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (RO1 ARO 47328)
This publication has 15 references indexed in Scilit:
- 2012 Update of the 2008 American College of Rheumatology recommendations for the use of disease‐modifying antirheumatic drugs and biologic agents in the treatment of rheumatoid arthritisArthritis Care & Research, 2012
- Risk of Orthopedic Surgical Site Infections in Patients with Rheumatoid Arthritis Treated with Antitumor Necrosis Factor Alfa TherapyInternational Journal of Rheumatology, 2012
- BSR and BHPR rheumatoid arthritis guidelines on safety of anti-TNF therapiesRheumatology, 2010
- Risk factors for surgical site infections and other complications in elective surgery in patients with rheumatoid arthritis with special attention for anti-tumor necrosis factor: a large retrospective study.2007
- Patients with Rheumatoid Arthritis Undergoing Surgery: How Should We Deal with Antirheumatic Treatment?Seminars in Arthritis and Rheumatism, 2007
- Perioperative Management of Medications Used in the Treatment of Rheumatoid ArthritisHSS Journal®: The Musculoskeletal Journal of Hospital for Special Surgery, 2006
- BSR/BHPR guideline for disease-modifying anti-rheumatic drug (DMARD) therapy in consultation with the British Association of DermatologistsRheumatology, 2006
- Rates of serious infection, including site‐specific and bacterial intracellular infection, in rheumatoid arthritis patients receiving anti–tumor necrosis factor therapy: Results from the British Society for Rheumatology Biologics RegisterArthritis & Rheumatism, 2006
- Update on the British Society for Rheumatology guidelines for prescribing TNF blockers in adults with rheumatoid arthritis (update of previous guidelines of April 2001)Rheumatology, 2005
- Methotrexate and early postoperative complications in patients with rheumatoid arthritis undergoing elective orthopaedic surgeryAnnals Of The Rheumatic Diseases, 2001