TNF and infection: The 2005 British Society for Rheumatology (BSR) anti-TNFα (Tumour necrosis factor α) guidelines base perioperative advice upon drug company recommendations, stating that “treatment with infliximab, etanercept, and adalimumab should be withheld for 2 to 4 weeks prior to major surgical procedures.” They recommend restarting treatment when wound healing is satisfactory, and there are no signs of infection [12].