Does prednisolone and enbrel inhibit wound healing and should I stop them before a tummy tuck?

Question

I am 35 years old and have rheumatoid arthritis (diagnosed at 3). I have been taking prednisolone for 12 years at 5mg a day. 7 weeks ago I began enbrel (tnf inhibitor) and this has worked so well that I am coming off the steroids. I have booked a full tummy tuck and will be 2 weeks clear of steroids at that point. I will also have missed 2 weekly doses enbrel. Will my wound healing be as good as someone not on steroids or will the yrs of taking steroids make it harder for me to heal?

Kenneth Hughes, MD · Answer

There can be a host of issues that factor into delayed wound healing including infection, foreign body, poor vascular supply, irritation from any source, etc. It would be difficult to advise without following your particular course, and examining you. Derangements in wound healing resulting in undesirable scarring may derive from inadequate or excessive inflammation. Inadequate inflammation may be a consequence of poor nutrition, systemic steroids or other problems and can generate an inadequate stimulus to scar formation. This can result in an atrophic, excessively wide scar. Suggest that you consult with your board certified plastic surgeon immediately to share your medical history.

Daniel Barrett, MD · Answer

Dear shaunyboo123,
every plastic surgeon has his own postoperative protocol which he recommends to his patients. Generally speaking, steroids increase the risk of complications. I would suggest you to discuss this with your plastic surgeon.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

It is important that you discuss these concerns with your surgeon.  Time frames for being off certain medications will vary by surgeon preference.  Be sure to discuss all medications you take including over the counter and supplements.  It is important that you are comfortable and confident as you prepare for surgery.

Mats Hagstrom, MD (license on probation) · Answer

You are in a very tricky situation and being off steroids for two weeks may be insufficient.

I would personally recommend having your rheumatologist consult with your plastic surgeon and discuss timing and if stress doses of steroids are indicated during and after the procedure.

I’m not sure if your adrenal glands will have come back to normal functioning after having been on steroids for that long.

This should definitely be discussed with your plastic surgeon well in advance and everyone needs to be on board and have a solid plan for you.

If you have surgery scheduled then I’m assuming this is been reviewed with your plastic surgeon.

If not please contact your surgeon and explain your full medical history as soon as possible.

Best,

Mats Hagstrom MD

Does prednisolone and enbrel inhibit wound healing and should I stop them before a tummy tuck?

Answers (4)

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