Effects of Perioperative Antiinflammatory and Immunomodulating Therapy on Surgical Wound Healing

Anthony J. Busti, PharmD; Justin S. Hooper, PharmD; Christopher J. Amaya, PharmD; Salahuddin Kazi, MBBS


Pharmacotherapy. 2005;25(11):1566-1591. 

In This Article


All patients with autoimmune diseases requiring immunomodulating therapy who are undergoing surgery should be monitored carefully for the development of infection as well as disease flare-ups. Data are limited, and in some cases inconsistent, regarding the use of immunomodulating therapy in the perioperative period. In some cases, our decision-making relies on the extrapolation of results from animal studies to clinical practice. Health care providers should consider the patient's comorbidities, risk factors for postoperative complications, and the pharmacokinetics and pharmacodynamics of corticosteroids, NSAIDs, COX-2-selective inhibitors, DMARDs, and biologic response modifiers when making final decisions regarding these agents' perioperative use. More prospective, controlled studies are needed to define the effects of these agents on the process of bone and wound healing in the surgical setting.


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