[Multidisciplinary expert consensus on tophus damage grading and surgical treatment (2025 edition)].

Tophi, a severe complication of advanced gout, develop in approximately 12% to 53% of patients with gout. The treatment of bone and joint damages and chronic refractory wounds caused by tophi presents considerable clinical challenges. Currently, there is no unified standard for the optimal surgical timing, perioperative management, and treatment approaches for this condition. To address this, the Wound Repair Professional Committee of Chinese Medical Doctor Association convened a multidisciplinary panel of senior experts in wound repair, plastic surgery, orthopedics & joint surgery, rheumatology and immunology, radiology, and nursing and wound management. Based on the literature evidence combined with expert opinion, the panel employed nominal group and Delphi methods, and a grading standard (levels 1 to 4) defining the extent of tophi damage and the treatment principle were established for the first time to ensure homogeneity of surgical treatment; 14 recommendations on the diagnosis and treatment of tophi were proposed, providing practical guidance for the surgical treatment of tophi.