Melbourne Hand Surgery 

COVID news: Elective surgery restrictions have been lifted and we will resume all elective surgeries from 28 September. Please note that all patients who are scheduled for elective surgery admission are required to undertake a COVID test, to obtain a negative ("not infected") result prior to admission, and to self-isolate from the time of test to admission. As Epworth Cliveden remains indefinitely closed at this time Dr Tomlinson does not have any regular surgical lists at Epworth, but her lists continue at The Avenue and Glenferrie Private. 

All suitable consultations at Melbourne Hand Surgery are currently conducted via telehealth (phone or video consultation) to maximise patient and staff safety. We have implemented enhanced hygiene meaures in our rooms including acrylic screens, masks, hand sanitiser, face shields and physical distancing-related changes. We are closed on Fridays.

Victorians are in this together and together we will get through this. Thank you for your understanding as our community works through these unprecedented times together (last updated: 22 September 2020).

Gout is predominantly treated with medications, rather than with surgery. Nonetheless there are instances where surgery is helpful for individuals who have gout. 

Acute gout

Acute gout can present in a similar way to an infected joint or an infection of the soft tissues. In this instance surgery may be performed to "wash out" the area, obtaining tissue and fluid samples that are sent for testing to exclude the possibility of infection and confirm the diagnosis of gout. The wash out can also speed the resolution of the gout attack, by washing out the uric acid crystals.

Surgery is only performed in acute gout when it is not possible to confirm whether there is concomitant infection. In such circumstances surgery is performed because it is safer to proceed on the assumption that infection is present when it is not, than to assume that it is "just gout" when there may be an infection destroying the joint.

Chronic gout

Chronic gout can have multiple effects. Most individuals are aware that they have suffered recurrent acute attacks of gout, but it is possible to have chronic low grade gout that creates significant problems without acute attacks of pain, redness and inflammation. 

Chronic gout can lead to the deposition of uric acid crystals in tendons, resulting in

These conditions can be treated with carpal tunnel release and trigger finger surgery

Chronic gout can also lead to the deposition of uric acid crystals in tophi that distort the fingers and in ways that destroy joints. Surgery can be beneficial in such circumstances, although it is not a cure for gout and must be combined with medical treatment under the care of a specialist physician.

 

FRACS

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