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. 

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: 16 September 2020).

Rheumatoid arthritis, medications and surgery

 

capsules 200x150Decisions to stop or continue medications before or after surgery need to take into consideration your medical conditions as well as the type of surgery. For minor procedures that are performed under local anaesthetic there is usually no need to stop regular medications for rheumatoid arthritis, but for larger procedures it may be recommended to stop the medication prior to surgery and recommence it once your wounds have healed (usually 2 weeks after surgery). Current evidence suggests:

Medication Perioperative management
NSAIDs Continue for hand surgery unless unusually high bleeding risk exists
Methotrexate Continue
Sulfasalazine Insufficient data
Azathioprine Insufficient data
Cyclophosphamide Insufficient data
Cyclosporine Discontinue 3-4 days before surgery, recommence after wounds have healed
Hydroxychloroquine Discontinue prior to surgery; recommence after wounds have healed
Penicillamine Discontinue on day of surgery, recommence after wounds have healed
Leflunomide® Insufficient data
Infliximab® Insufficient data
Etanercept® Insufficient data
Adalimumab® Insufficient data
Hydrocortisone Continue
Prednisolone Continue
Methylprednisolone Continue
Dexamethasone Continue

Reference

Thorsness RJ, Hammert WC. Perioperative management of rheumatoid medications. J Hand Surg AM 2012; 37A; p1928-1931

 

FRACS

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.

Search only trustworthy HONcode health websites: