[Case Interpretation] What should I do if the tophi ruptures?

Case|Tophi rupture

A 53-year-old man presented with an 18-year history of gout with a 13-day exacerbation of skin ulceration of the right ankle

Causes of tophi rupture and difficult to heal

1.

Because the most fundamental reason for the formation of tophi is the continuous increase of uric acid, controlling the level of uric acid has become the top priority in the prevention and treatment of tophi

How to deal with ruptured tophi

In the event of an emergency tophi rupture, it is difficult to do aseptic treatment at home, and secondly, it is difficult to clean up these corrosive uric acid crystals by yourself, the wound is difficult to recover, and even becomes infected

Case|Tophi rupture

Case| Patient with ruptured tophi, a 53-year-old man with an 18-year history of gout with exacerbation and 13-day skin rupture of the right ankle

Causes of tophi rupture and difficult to heal

Reasons for tophi rupture and refractory healing Reasons for tophi rupture and refractory healing 1．Due to long-term chemical stimulation and erosion, the skin where tophi is formed will damage the skin structure and nutrition, the local blood circulation is poor, and the cell regeneration ability is low, which affects its repair 2.

What should I do if I have tophi? What should I do if I have tophi?Because the most fundamental reason for the formation of tophi is the continuous increase of uric acid,so controlling the level of uric acid has become the top priority in the prevention and treatment of tophi

How to deal with ruptured tophi

How to deal with a ruptured tophi? What to do with a ruptured tophi?Once an emergency tophus rupture occurs, it is difficult to treat it at home.
First, it is difficult to do aseptic treatment.
Second, it is difficult to clean up these corrosive uric acid by yourself.
Crystals, the wound is difficult to recover, and even becomes infected.
Therefore, it is recommended to go to surgical debridement as soon as possible.
In addition, the following suggestions are put forward for patients with tophi rupture at different stages:(1) Keep the local wound clean, wash the wound with normal saline and antiseptic solution every day, Remove as much urate from the nodule as possible to speed up wound healing.
  (2) Due to the rupture of a large tophi with a wide range and a long period of rupture, it is difficult to heal by itself, and surgical resection is required.
(3) If there is a concurrent infection, fever and elevated white blood cells, they should be admitted to the hospital for treatment, so as not to delay the disease and cause adverse consequences.
For those with local purulent fluid, it needs to be taken for bacterial culture and drug susceptibility test to guide the selection of which antibiotic to use .
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