Application of medical pulsed irrigation gun for incision irrigation in removal surgery of tophi in the first metatarsophalangeal joint of patients with erosive gout
WANG Wei
ZHU Chunlei
WANG Xuecheng
WANG Tianbin
HE Ge
Abstract：Objective To observe the clinical effect of using a medical pulsed irrigation gun to irrigate the incision during removal surgery of tophi in the first metatarsophalangeal joint of patients with erosive gout.Methods Twenty pa-tients with erosive gout who underwent tophus removal surgery in the first metatarsophalangeal joint using a medical pulsed irrigation gun for incision irrigation were selected as the observation group,and 20 patients with erosive gout who used the traditional pouring method for incision irrigation were selected as the control group.Their clinical data were retrospectively analyzed,and we compared the irrigation time and irrigation fluid volume,serum uric acid(UA)and C-reactive protein(CRP)levels before surgery and 1 day after surgery,the number of cases with increased or decreased serum UA and CRP levels 1 day postoperatively,pain visual analog scale(VAS)scores before surgery and 3 days after surgery,the American Orthopaedic Foot and Ankle Society(AOFAS)first metatarsophalangeal joint functional scores at admission and 3 months postoperatively,and incision healing status 14 days after surgery.Results The irrigation time in the observation and control group was(2.75±0.55)and(5.97±0.80)minutes,respectively,and the irrigation fluid volumes were(1 285.00±168.66)mL and(2 315.00±365.30)mL,respectively;significant differences were found between the two groups(all P<0.05).Compared with the preoperative levels,the serum UA and CRP levels in the control group showed no significant changes on postoperative day 1(all P>0.05),while those in the observation group both decreased(all P<0.05).The serum UA and CRP levels on postoperative day 1 in the observation group were lower than those in the control group(both P<0.05).The proportion of patients with decreased serum UA and CRP levels on postoperative day 1 in the observation group was higher than that in the control group(P<0.05).Compared with the preoperative levels,VAS scores decreased to varying degrees in both groups at 3 days after surgery(all P<0.05).Compared with the preoperative levels,AOFAS scores increased in both groups at 3 months after surgery(both P<0.05);no significant difference was found in the AOFAS score between the observation group and control group at 3 months postoperatively(P>0.05).Incision healing in the observation group was grade A in 15 cases(75%),grade B in 4 cases(20%),and grade C in 1 case(5%),while in the control group,these were 5 cases(25%),12 cases(60%),and 3 cases(15%),respectively;the proportion of grade A incision healing was higher in the observation group than in the control group(P<0.05).Conclusion Using a medical pulsed irrigation gun to irrigate the incision during tophus removal surgery in patients with erosive gout shortens ir-rigation time,helps reduce postoperative inflammatory response and pain,promotes incision healing,and aids in the re-covery of first metatarsophalangeal joint function.
Keywords：gouttophusthe first metatarsophalangeal jointmedical pulsed irrigation guntraditional pouring method
Publication Date：2025-06-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 47-51 )