oa Wound Healing Southern Africa - Tophaceous gout lesions : problem wounds with complex management needs : case study



Hyperuricaemia is the underlying cause of a condition commonly known as gout. Patients with hyperuricaemia may be asymptomatic for life or may experience frequent attacks of painful gouty arthritis. Gout is, therefore, a condition with both acute and chronic characteristics.

It is a priority of the management of chronic gout to lower the serum urate (SU) level to below 6 mg/dL, which is the goal range. Failure to do so allows the SU level to cross the limit of solubility in the body. Once that threshold is crossed, it ultimately results in the laying down of uric acid deposits in joints and soft tissue, as the ability of the kidneys to clear the body of uric acid is reduced. The long term complications of poorly controlled uric acid levels include recurrent acute incidences of flare-up and the development of tophaceous gout.


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