Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Eighty patients with rheumatoid arthritis who had 129 surgical procedures on the hand and wrist over a 5-year period were reviewed. All patients continued with their usual medication throughout the perioperative period. There were 2 pin track infections and 1 wound infection in patients taking methotrexate alone (3 of 48), 1 wound dehiscence in a patient taking steroids without methotrexate (1 of 30), 1 wound infection in a patient taking both drugs (1 of 30), and 2 wound infections in patients taking neither of these drugs (2 of 21). There was no statistically significant risk of wound infection or breakdown in patients taking methotrexate or steroids or both. Rheumatoid patients with diabetes had an increased risk of wound infection (33%) compared with patients without (3.3%). No disease flare-ups occurred within 3 months of surgery. We recommend that these drugs be continued throughout the surgical and postoperative rehabilitation period.

Original publication

DOI

10.1053/jhsu.2002.32958

Type

Journal article

Journal

The Journal of hand surgery

Publication Date

05/2002

Volume

27

Pages

449 - 455

Addresses

Department of Musculoskeletal Surgery and the Kennedy Institute of Rheumatology, Imperial College School of Medicine, Charing Cross Hospital, London, England.

Keywords

Wrist Joint, Humans, Surgical Wound Infection, Hand Deformities, Acquired, Arthritis, Rheumatoid, Methotrexate, Prednisolone, Drug Therapy, Combination, Preoperative Care, Surgical Procedures, Elective, Probability, Risk Assessment, Retrospective Studies, Follow-Up Studies, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Male