Barnard A R, Regan M, Burke F D, Chung K C, Wilgis E F S
Pulvertaft Hand Centre, Kings Treatment Centre, Royal Derby Hospital, Uttoxeter Road, Derby DE22 3NE, UK.
ISRN Rheumatol. 2012;2012:251962. doi: 10.5402/2012/251962. Epub 2012 Dec 3.
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.
引言。用于治疗类风湿性关节炎的药物，如皮质类固醇、病情改善药物（DMARDs）和注射用生物制剂（抗TNFα），可能对伤口愈合产生广泛影响。在手部手术中，重要的是要权衡继续用药导致伤口愈合不良的风险与暂时停药引发类风湿性关节炎病情复发的风险。材料与方法。英国一组28例患者接受了35只手（140处伤口）的掌指关节置换手术。除注射用生物制剂外，类风湿性关节炎的所有药物在围手术期均持续使用。结果。没有伤口裂开或深部感染的情况，仅有一例轻微浅表感染。结论。我们得出结论，只要注意及时识别和处理任何问题，在手部手术的围手术期继续使用大多数抗类风湿药物以降低破坏患者整体类风湿疾病控制稳定性的风险是合适的。
