Use of platelet‐rich plasma in treating a wound infection following tophi rupture: A case report

Abstract

Gout is a common crystal-related joint disease that result from the deposition of monosodium urate in the joint space. Gouty arthritis is a metabolic disease that could be stratified with the activity of the disease into asymptomatic gout, acute gout, interval gout, and chronic tophaceous gout. 1 Tophus formation contains a large number of monosodium urate crystals and surrounding inflammatory cells and connective tissue. The development of tophus is common in patients with uncontrolled serum urate and leads to severe and chronic gout. 2 The formation of subcutaneous tophus leads to erosion of surrounding bone and the soft tissues and development of a yellow-white neoplasm. In severe cases, tophi could result in joint deformities, bone destruction, skin ulcers, and discharge of powdery or pasty substances from wounds; thus, the wound healing is a difficult challenge. 3 Ensuring the proper wound management leads to successful treatment of ruptured tophus.Platelet-rich plasma (PRP) is a high-concentration platelet plasma obtained by centrifugation based on the difference of sedimentation coefficient of whole blood components. 4 PRP contains 3-6 times platelet compared to the baseline in plasma and various biologically active substances such as cytokines that promote tissue repair and regeneration. PRP is widely used in the treatment of various diseases, including case report of treatment in crystal-related arthritis, but outcomes are inconsistent. 5 We intend to report a 34-year-old man, employed in a bar and habitually consuming alcohol for over 10 years, reported an 8-year history of polyarthralgia. He was admitted due to a persistently rupturing wound on his left foot, which had been worsening for 10 days. At initial, he observed a painful, swollen, erythematous lump on his left foot, which ruptured, discharging white material, and leading to an expanding wound. Despite the debridement and antibiotics