Surgical treatment of subcutaneous tophaceous gout

Multiarticular chronic tophaceous gout with severe and multiple ulcerations: a case report

“…Removal of tophaceous deposits from the hands can be achieved through tenosynovectomy for heavily infiltrated tendons, through a soft-tissue shaving technique for heavy skin infiltration with ulceration and draining fissures [13], or through more complex surgical approaches involving large skin incisions and excision of the tophi [14]. A hydrosurgery system applying a highly pressurized saline stream has also been used with good results for the debridement of tophi [15]. In the early stages, surgical arthroplasty can be carried out, but simple enucleation of the tophi may lead to complications such as skin necrosis, tendon and joint exposures [11].…”

Unusual Gouty Tophi Simulating Malignancy

“…Also, some other minimal invasive techniques were reported previously. [4][5][6] With the advent of the disease, a tophus may cause persistent pain that impairs foot function, superimposed infection and uncontrolled drainage, or enlargement of a digit. Thereby, amputation may become the last and undesired option.…”

Ulcerated tophaceous gout

“…General indications for surgery include infection of tophi, ulcerated tophi, mechanical impairments, uncontrollable pain and cosmesis 16 17. Classic curettage and debridement can be used to remove tophi, however, this technique has high rates of delayed wound healing and skin necrosis 18. Thus, other techniques, such as shaving and hydrosurgery, have been developed 17 18.…”

“…Classic curettage and debridement can be used to remove tophi, however, this technique has high rates of delayed wound healing and skin necrosis 18. Thus, other techniques, such as shaving and hydrosurgery, have been developed 17 18. In addition, skin grafting can be performed 9.…”