Document Detail

Influence of steroids and methotrexate on wound complications after elective rheumatoid hand and wrist surgery.
MedLine Citation:
PMID:  12015719     Owner:  NLM     Status:  MEDLINE    
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.
Abhilash Jain; Melinda Witbreuk; Cathy Ball; Jagdeep Nanchahal
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  27     ISSN:  0363-5023     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-05-16     Completed Date:  2002-07-08     Revised Date:  2009-06-08    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  449-55     Citation Subset:  IM    
Department of Musculoskeletal Surgery and the Kennedy Institute of Rheumatology, Imperial College School of Medicine, Charing Cross Hospital, London, England.
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MeSH Terms
Aged, 80 and over
Arthritis, Rheumatoid / drug therapy*,  surgery*
Drug Therapy, Combination
Follow-Up Studies
Hand Deformities, Acquired / surgery*
Methotrexate / administration & dosage*,  adverse effects
Middle Aged
Prednisolone / administration & dosage*,  adverse effects
Preoperative Care
Retrospective Studies
Risk Assessment
Surgical Procedures, Elective / methods
Surgical Wound Infection / epidemiology,  etiology*
Wrist Joint / physiopathology,  surgery
Reg. No./Substance:
50-24-8/Prednisolone; 59-05-2/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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