When should gout be treated surgically? Never wait! The orthopedic surgeon called the roll three times.

72-year-old Cai Bobo often eats seafood with beer because of family inheritance and work relationship, which makes him have gout attacks since childhood. With the increase of age, gout attacks become more and more frequent, and even crystals grow on hands, feet and knees. However, due to the erosive effect of gout stones on ligaments and joints, traditional surgery is easy to cause large-scale wounds and complications. Cai Bobo has been in a state of not making up his mind to operate, dragging on for decades until his feet are deformed and he can't wear shoes.

The ultrasonic scalpel "cuts soft but not hard", and the scalpel vibrates at high speed to reduce unnecessary injuries.

Kevin Wu, an orthopedic surgeon at Yadong Hospital, said that the "ultrasonic scalpel" used in the removal of tophi was not a traditional scalpel. It is an instrument that uses ultrasonic high-speed vibration to crush tophi and wash it out. Its characteristic is "cutting soft but not hard". Different from traditional scalpels, ultrasonic scalpel can crush tophi without damaging muscles, nerves or cartilage, thus reducing unnecessary injuries.

Reduce the operation area and the high probability of not needing hospitalization after operation, and reduce the risk of complications of chronic diseases.

Kevin Wu further explained that ultrasonic knives are different from traditional knives. The surgical wound is smaller than 1 yuan coin, and sometimes there is only a small hole. Small wound and quick recovery can greatly reduce the infection rate. For some people suffering from cardiovascular diseases, metabolic diseases or diabetes, minimally invasive ultrasonic scalpel surgery only needs half-body anesthesia or local anesthesia, which is not easy to cause complications and reduces the risk of major surgery or general anesthesia.

If there are not too many nerves and blood vessels in the position of tophus, it is not in the common joints, and the surface is shallow, and the deposited stones are not large. Generally, you don't need to be hospitalized after the operation, and you can go home immediately. However, judging whether to be hospitalized after surgery, Kevin Wu pointed out that it is necessary to evaluate the patient's uric acid control status first, and then make auxiliary observation through X-ray or ultrasound, which cannot be judged from the appearance; If patients have more than one or more tophi removed at a time, or need drainage after tophi removal, it is still recommended to be hospitalized for observation.

Kevin Wu mentioned that more than 90% patients can walk after anesthesia if the tophi does not invade the joints, and even some patients with smaller or shallower tophi have no abnormal feeling after operation. The doctor also suggested that patients should take good care of the affected area for 7- 10 days, keep the wound clean, and at the same time "avoid eating", drink more water, reduce the inflammatory index, and avoid going to see a doctor again because of uric acid is too high in the recovery period.

Gout surgical treatment affects life, and the doctor's advice can be implemented.

Under what circumstances do you need surgery to remove stones? Kevin Wu said that surgery can be considered when the attending physician says that surgery is needed, or if tophi has affected daily life and the drug dissolution effect is limited. However, don't wait and see until the joint is deformed and the tophi is swollen to the skin before you are willing to operate. If severe gout stones are removed at this time, it will destroy the blood circulation of the superficial skin, which will easily lead to skin necrosis around the joints after operation, increase the risk of surgery, and the wound is more difficult to heal, and severe cases may face amputation.