Reconstruction of an extensive gouty tophus ulceration at the wrist using a dermal matrix and autologous skin graft: A case report

The staged reconstruction protocol, which combines dermal substitution with autologous skin grafting, delivers durable soft tissue coverage and functional preservation in complex wrist gout ulcerations. This approach represents a less morbid and technically feasible alternative to traditional flap surgery, particularly in high-risk patients with multiple comorbidities. Excellent mid-term outcomes were observed, including 24-month recurrence-free survival.