Moderne rheumatische Basistherapie perioperativ

Abstract

BACKGROUND: The study objective was to examine whether the perioperative interruption or continuation of disease modifying drugs in rheumatoid arthritis (DMARD) favours episodes of rheumatoid arthritis or impairs the course of wound healing. A special focus was to establish a possible connection between the kind of perioperative drug administration (continuous or interrupted) and the development of wound-healing impairment or episodes thereof. PATIENTS AND METHODS: A total of 140 patients were examined with respect to postoperative impairment of wound healing. All patients suffered from rheumatoid arthritis, had treatment according to state-of-the art DMARDs and had undergone typical surgeries at different joints. The patients were subdivided into 5 main groups, with special focus on the perioperative drug administration. RESULTS: In the total of 140 cases examined 8.5 % showed impaired wound healings, while 91.4 % exhibited primary wound healings. The patient group with interrupted medication (groups 1A-5A) showed a total of 7.1 % impaired wound healing compared to 10 % in the group with continued perioperative medication (groups 1W - 5W). CONCLUSION: Thus, DMARD seems to act indifferently with respect to the wound healing process. As far as Leflunomide is concerned, no clear statement can be made as yet.