Xu Jianjun, Zhu Zaihua, Zhang Wei
1 Department of Burns, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
2 Division of Rheumatology and Immunology, Huashan Hospital, Fudan University, Shanghai 200040, China.
J Int Med Res. 2018 Jun;46(6):2258-2264. doi: 10.1177/0300060518761303. Epub 2018 Mar 27.
Objective The aim of this study was to investigate the clinical characteristics of infectious ulceration over tophi in patients with gout. Methods Participants were recruited from the First Affiliated Hospital of Wenzhou Medical University. The clinical characteristics of the patients and wound characteristics were recorded. Results Of the 38 enrolled patients, 18 were found to have infectious ulceration over tophi. Staphylococcus aureus was the most common pathogen and was identified in nine patients. Patients with infection were significantly older (69.6 vs. 60.1 years) and had a worse quality of life than those without infection. Patients with infection also had a significantly longer ulcer duration (125.6 vs. 54.2 days), larger ulcer size (2.47 vs. 1.99 cm), a higher rate of tissue necrosis in the ulcer bed (55.6% vs. 20.0%), a lower rate of callus at the edge (27.8% vs. 70.0%), and a higher moisture level than did patients without infection. Additionally, patients with infection had significantly delayed wound healing (35.3 vs. 20.3 days) compared with patients without infection. Conclusions Older patients with a long ulcer duration and larger ulcer size are more susceptible to infection. Infection can lower patients' quality of life and delay wound healing.
目的 本研究旨在探讨痛风患者痛风石感染性溃疡的临床特征。方法 研究对象来自温州医科大学附属第一医院。记录患者的临床特征和伤口特征。结果 在纳入的38例患者中，18例存在痛风石感染性溃疡。金黄色葡萄球菌是最常见的病原体，9例患者检出该菌。感染患者的年龄显著更大（69.6岁 vs. 60.1岁），生活质量比未感染患者差。感染患者的溃疡持续时间也显著更长（125.6天 vs. 54.2天），溃疡面积更大（2.47 cm vs. 1.99 cm），溃疡床组织坏死率更高（55.6% vs. 20.0%），边缘胼胝形成率更低（27.8% vs. 70.0%），且湿度水平高于未感染患者。此外与未感染患者相比，感染患者的伤口愈合明显延迟（35.3天 vs. 20.3天）。结论 溃疡持续时间长、溃疡面积大的老年患者更容易发生感染。感染会降低患者的生活质量并延迟伤口愈合。
