Postoperative infections after limb-sparing surgery for primary bone tumors of the pelvis: Incidence, characterization and functional impact.
Surg Oncol
; 26(2): 171-177, 2017 Jun.
Article
en En
| MEDLINE
| ID: mdl-28577723
ABSTRACT
INTRODUCTION:
Surgical site infections (SSI) represent the most common postoperative complication after limb sparing surgery for primary malignant bone tumors, with incidence ranging from 10 to 47%. There is no consensus concerning about the optimal surgical strategy, or the adequate antibiotic prophylaxis in pelvic resections. A greater knowledge of these infections and their surgical trajectories seem essential to obtain. MATERIALS ANDMETHODS:
We retrospectively studied 45 cases of pelvic resection, including at least the periacetabular zone 2 of Enneking, performed between 1989 and 2013 in the same center. Infection rate, risk factors and surgical trajectories were analyzed. The impact of a postoperative infection on the quality of life and functional recovery was evaluated by the Musculoskeletal Tumor Society scoring system (MSTS).RESULTS:
Sixteen patients presented a SSI in the first post-operative year (35.6%). We found as risk factors the pre-operative ASA score, the age at surgery and the number of packed red cells transfused during surgery. In case of failure of an initial washout, an iterative procedure is responsible for a high failure rate of 88.9%. Irrespective of the type of reconstruction, our functional results show that this surgery is often a source of handicap with a MSTS score of 13.77 in infected patients versus 17.70 in non-infected patients, at two-year follow-up.DISCUSSION:
In case of failure of an initial wash, prosthetic material must be removed and a hip transposition procedure should be preferred to a second-look surgery. Concerning prophylactic antibiotherapy, a dual therapy for at least 48 h after surgery should probably be preferred.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias Pélvicas
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Complicaciones Posoperatorias
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Infección de la Herida Quirúrgica
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Neoplasias Óseas
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Recuperación del Miembro
/
Tratamientos Conservadores del Órgano
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Surg Oncol
Asunto de la revista:
NEOPLASIAS
Año:
2017
Tipo del documento:
Article