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Persistent wound drainage after tumor resection and endoprosthetic reconstruction of the proximal femur.

Hettwer WH, Horstmann PF, Grum-Schwensen TA, Petersen MM - Open Orthop J (2014)

Bottom Line: PWD for 7 days or more was observed in 41 cases (48%).The wounds only ceased oozing after a mean of 8.4 days, leading to prolonged administration of prophylactic antibiotics (mean 8.7 days) and length of hospital stay (mean 10.2 days).Given the potentially increased risk for periprosthetic joint infection (PJI), increased awareness, identification and implementation of adequate strategies for prevention and treatment of this avoidable complication are warranted.

View Article: PubMed Central - PubMed

Affiliation: Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Denmark.

ABSTRACT

Purpose: To examine the prevalence of prolonged wound drainage (PWD) after tumor resection and endoprosthetic reconstruction of the hip.

Methods: Retrospective review of 86 consecutive patients with metastatic bone disease, malignant hematologic bone disease or bone sarcoma, treated with tumor resection and subsequent endoprosthetic reconstruction of the proximal femur, between 2010 and 2012, in a single center.

Results: PWD for 7 days or more was observed in 41 cases (48%). The wounds only ceased oozing after a mean of 8.4 days, leading to prolonged administration of prophylactic antibiotics (mean 8.7 days) and length of hospital stay (mean 10.2 days). Total femur replacement, bone sarcoma and additional pelvic reconstruction were identified as significant independent risk factors for an even longer duration of PWD.

Conclusion: Compared to conventional hip arthroplasty, PWD appears to be significantly more prevalent in patients undergoing tumor arthroplasty procedures of the hip. Given the potentially increased risk for periprosthetic joint infection (PJI), increased awareness, identification and implementation of adequate strategies for prevention and treatment of this avoidable complication are warranted.

No MeSH data available.


Related in: MedlinePlus

Kaplan Meier survival analysis showing cumulative survival rate (solid line) and 95% confidence interval (dotted lines) for allpatients (n=86), who had an endoprosthetic reconstruction of the hip and proximal femur for malignant bone disease between 2010 and 2012.
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Figure 2: Kaplan Meier survival analysis showing cumulative survival rate (solid line) and 95% confidence interval (dotted lines) for allpatients (n=86), who had an endoprosthetic reconstruction of the hip and proximal femur for malignant bone disease between 2010 and 2012.

Mentions: As an indirect measure for severity of the underlying disease, we performed an analysis of overall patient survival. Ten patients died within the first 30 post- operative days and probability of overall survival was 74% at 3 months, 63% at 6 months and 45% at 1 year (Fig. 2), indicating that most patients were in advanced stages of their underlying disease.


Persistent wound drainage after tumor resection and endoprosthetic reconstruction of the proximal femur.

Hettwer WH, Horstmann PF, Grum-Schwensen TA, Petersen MM - Open Orthop J (2014)

Kaplan Meier survival analysis showing cumulative survival rate (solid line) and 95% confidence interval (dotted lines) for allpatients (n=86), who had an endoprosthetic reconstruction of the hip and proximal femur for malignant bone disease between 2010 and 2012.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4300510&req=5

Figure 2: Kaplan Meier survival analysis showing cumulative survival rate (solid line) and 95% confidence interval (dotted lines) for allpatients (n=86), who had an endoprosthetic reconstruction of the hip and proximal femur for malignant bone disease between 2010 and 2012.
Mentions: As an indirect measure for severity of the underlying disease, we performed an analysis of overall patient survival. Ten patients died within the first 30 post- operative days and probability of overall survival was 74% at 3 months, 63% at 6 months and 45% at 1 year (Fig. 2), indicating that most patients were in advanced stages of their underlying disease.

Bottom Line: PWD for 7 days or more was observed in 41 cases (48%).The wounds only ceased oozing after a mean of 8.4 days, leading to prolonged administration of prophylactic antibiotics (mean 8.7 days) and length of hospital stay (mean 10.2 days).Given the potentially increased risk for periprosthetic joint infection (PJI), increased awareness, identification and implementation of adequate strategies for prevention and treatment of this avoidable complication are warranted.

View Article: PubMed Central - PubMed

Affiliation: Musculoskeletal Tumor Section, Department of Orthopedic Surgery, Rigshospitalet, University of Copenhagen, Denmark.

ABSTRACT

Purpose: To examine the prevalence of prolonged wound drainage (PWD) after tumor resection and endoprosthetic reconstruction of the hip.

Methods: Retrospective review of 86 consecutive patients with metastatic bone disease, malignant hematologic bone disease or bone sarcoma, treated with tumor resection and subsequent endoprosthetic reconstruction of the proximal femur, between 2010 and 2012, in a single center.

Results: PWD for 7 days or more was observed in 41 cases (48%). The wounds only ceased oozing after a mean of 8.4 days, leading to prolonged administration of prophylactic antibiotics (mean 8.7 days) and length of hospital stay (mean 10.2 days). Total femur replacement, bone sarcoma and additional pelvic reconstruction were identified as significant independent risk factors for an even longer duration of PWD.

Conclusion: Compared to conventional hip arthroplasty, PWD appears to be significantly more prevalent in patients undergoing tumor arthroplasty procedures of the hip. Given the potentially increased risk for periprosthetic joint infection (PJI), increased awareness, identification and implementation of adequate strategies for prevention and treatment of this avoidable complication are warranted.

No MeSH data available.


Related in: MedlinePlus