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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

Patient distribution with regard to the day of dry surgical wound, the length of antibiotic treatment, and the length of admission.
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Figure 3: Patient distribution with regard to the day of dry surgical wound, the length of antibiotic treatment, and the length of admission.

Mentions: Prolonged wound drainage of 7 days or more was observed in 41 cases (48%), and on average, the surgical wound was dry after a mean of 8.4 days (3-24 days), (Fig. 3). When focusing on selected subgroups, we found an even longer duration of PWD in patients with total femur replacement (p=0.005), a primary diagnosis of bone sarcoma (p=0.047) and in patients who required additional pelvic reconstruction (p=0.058). We found no association of wound drainage with overall survival, the extent of the proximal femoral resection or whether the patients had received preoperative radiotherapy or not (Table 2).


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)

Patient distribution with regard to the day of dry surgical wound, the length of antibiotic treatment, and the length of admission.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Patient distribution with regard to the day of dry surgical wound, the length of antibiotic treatment, and the length of admission.
Mentions: Prolonged wound drainage of 7 days or more was observed in 41 cases (48%), and on average, the surgical wound was dry after a mean of 8.4 days (3-24 days), (Fig. 3). When focusing on selected subgroups, we found an even longer duration of PWD in patients with total femur replacement (p=0.005), a primary diagnosis of bone sarcoma (p=0.047) and in patients who required additional pelvic reconstruction (p=0.058). We found no association of wound drainage with overall survival, the extent of the proximal femoral resection or whether the patients had received preoperative radiotherapy or not (Table 2).

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