Introduction. Medications used to treat
rheumatoid arthritis, such as
corticosteroids, disease-modifying agents (DMARDs), and
injectable biological agents (anti-TNFα), may have widespread effects on wound healing. In hand surgery, it is important to balance the risks of poor wound healing from continuing a medication against the risks of a flare of
rheumatoid arthritis if a
drug is temporarily discontinued. Materials and Methods. A United Kingdom (UK) group of 28 patients had metacarpophalangeal joint replacement surgery in 35 hands (140
wounds). All medication for
rheumatoid arthritis was continued perioperatively, except for the
injectable biological agents. Results. There were no instances of
wound dehiscence or deep
infection and only one episode of minor superficial
infection. Conclusions. We conclude that provided care is taken to identify and treat any problems promptly, it is appropriate to continue most antirheumatoid medications in the
perioperative period during hand surgery to reduce the risk of destabilising the patients' overall rheumatoid disease control.