[D-penicillamine and wound healing in patients with rheumatoid arthritis]

The inhibiting effect of D-penicillamine on the collagen metabolism in animal experiments and in some published clinical observations appear to confirm the assumption that this drug might retard the wound healing after surgery. Therefore the authors studied wound healing following 107 orthopedic operations in 49 RA patients: 36 operations on patients without any basic treatment, 48 during D-PA, 18 during gold, 4 during azathioprine and 1 during Resochin. Retarded wound healing (up to 4 weeks after the date of the operation) was observed 6 times: in 2 out of 36 operations (5.5%) in those without basic treatment, in one out of 48 (2.1%) during D-PA (600 mg/day), in 3 out of 18 (16.6%) during gold therapy. Operative re-interventions because of disturbances in the wound healing or infections were not needed. Based on these observations and the fact that authors who have observed an inhibition of the collagen synthesis have used an uncomparibly higher dosage per kilogram of body weight, the authors of this report are so far of the opinion that the dosage they are using (300-600 mg/day) does not significantly influence the speed of wound healing. Thus the basic treatment must not be interrupted before or after an operation.