Effect of methotrexate on bone and wound healing

Abstract

Methotrexate (MTX) is one of the most commonly used disease modifying drugs administered for wide spectrum of conditions. Through the expansion of the indications of MTX use, an increasing number of patients nowadays attend orthopaedic departments receiving this pharmacological agent. The aim of this manuscript is to present our current understanding on the effect of MTX on bone and wound healing. Areas covered: The authors offer a comprehensive review of the existing literature on the experimental and clinical studies analysing the effect of MTX on bone and wound healing. The authors also analyse the available literature and describe the incidence of complications after elective orthopaedic surgery in patients receiving MTX. Expert opinion: The available experimental data and clinical evidence are rather inadequate to allow any safe scientific conclusions on the effect of MTX on bone healing. Regarding wound healing, in vitro and experimental animal studies suggest that MTX can adversely affect wound healing, whilst the clinical studies show that lose-dose MTX is safe and does not affect the incidence of postoperative wound complications.

Effect and Repair Mechanism of Nano Ag Sponge Dressing Combined with Gelatin-Bletilla Striata Gum/Salvia Miltiorrhiza on Refractory Orthopedic Wounds

“…Porosity measurement: the GBS-Ag sponge dressing was made into a wafer with a diameter of 1 cm, and the thickness was measured with a vernier caliper and weighed as m 1 . The wafer was immersed in absolute ethanol and left for 2 hours to fully absorb the absolute ethanol till saturation, and it was taken out and weighted as m 2 , where ρ was the density of ethanol (0.785 g/cm 3 ) at 25°C, and V was the volume of the wafer before immersion in ethanol.…”

“…The healing of refractory wounds caused by large area soft tissue injury in orthopedics is a complex process, which is a dynamic process involving cells, biochemical reactions, and various enzymes, which run through the whole process of skin injury until the wound is completely healed [1]. Wound healing can be divided into four stages: hemostasis, inflammation, proliferation, and regeneration.…”

Correction of the Saddle Nose Deformity

“…7 Other literature studying its effects on bone and wound healing show that it is likely to be safe to operate on patients taking low doses. 8,9 Inflamed, crusted mucosa is a warning sign that there may be some active disease. These patients often have sinus disease and this may need to be treated also.…”

Recomendaciones perioperatorias y transoperatorias para la prevención de infecciones del sitio quirúrgico en ortopedia

“…4 Al tener en cuenta la evidencia muy limitada para el antifactor de necrosis tumoral o la falta de evidencia e incluso el daño potencial del metrotexato que apoyar la interrupción del tratamiento, y el riesgo asociado con la interrupción del tratamiento en el paciente con enfermedad subyacente, la medicación inmunosupresora no debe suspenderse con el fin de prevenir infección en el sitio quirúrgico. 5…”