schliessen

Filtern

 

Bibliotheken

Deep Infections after Endoprosthetic Replacement Operations in Orthopedic Oncology Patients

Background: Numerous studies have described various complications after endoprosthetic reconstructive operations. However, there are limited reports that focus specifically on deep infections (e.g., deep incisional surgical site infections), which remain one of the most dreaded complications of thes... Full description

Journal Title: Surgical infections 2015-06-01, Vol.16 (3), p.323-332
Main Author: Dhanoa, Amreeta
Other Authors: Ajit Singh, Vivek , Elbahri, Hassan
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States: Mary Ann Liebert, Inc
ID: ISSN: 1096-2964
Link: https://www.ncbi.nlm.nih.gov/pubmed/26046246
Zum Text:
SendSend as email Add to Book BagAdd to Book Bag
Staff View
recordid: cdi_proquest_miscellaneous_1686411695
title: Deep Infections after Endoprosthetic Replacement Operations in Orthopedic Oncology Patients
format: Article
creator:
  • Dhanoa, Amreeta
  • Ajit Singh, Vivek
  • Elbahri, Hassan
subjects:
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteria - drug effects
  • Bacteria - isolation & purification
  • Bacterial Infections - epidemiology
  • Bacterial Infections - pathology
  • Bone Neoplasms - surgery
  • Child
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Humans
  • Male
  • Middle Aged
  • Original Articles
  • Orthopedic Procedures - adverse effects
  • Reconstructive Surgical Procedures - adverse effects
  • Retrospective Studies
  • Soft Tissue Infections - epidemiology
  • Soft Tissue Infections - pathology
  • Surgical Wound Infection - epidemiology
  • Surgical Wound Infection - pathology
  • Young Adult
ispartof: Surgical infections, 2015-06-01, Vol.16 (3), p.323-332
description: Background: Numerous studies have described various complications after endoprosthetic reconstructive operations. However, there are limited reports that focus specifically on deep infections (e.g., deep incisional surgical site infections), which remain one of the most dreaded complications of these operations, with rates ranging from 10% to 17%. Thus, this study was undertaken to determine the deep infection rates and to analyze possible risk factors, clinico-pathologic characteristics, and treatment modalities of endoprosthetic infections. Methods: We reviewed retrospectively the records of 105 consecutive patients who underwent endoprosthesis replacements from January 2007 to September 2011, with a minimal follow-up period of 32 mo. Comparison was made between patients with and without endoprosthetic infections. Results: Thirteen of the 150 patients (12.38%) who underwent endoprosthetic operations developed deep infections. Ninety-seven (92.4%) patients presented with a primary bone/soft tissue tumor, 5 (4.8%) with bone metastasis, and 3 (2.9%) with non-tumor conditions. Distal femoral was the most common implant location (42%). The majority of the infections (6/13) occurred within 3 mo post-operation. An elevated C-reactive protein concentration or erythrocyte sedimentation rate were present consistently in all patients at time of diagnosis, whereas clinical presentations and leukocytosis were inconsistent in determining infection. Staphylococcus aureus and coagulase-negative staphylococci (CoNS) were the most common organisms isolated, with high numbers demonstrating methicillin-resistance. Overall, multi-drug resistance was noted in 52.6% of the isolated strains. Four risk factors were associated independently with deep infection by multivariable analysis (p
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1096-2964
fulltext: fulltext
issn:
  • 1096-2964
  • 1557-8674
url: Link


@attributes
NO1
SEARCH_ENGINEprimo_central_multiple_fe
SEARCH_ENGINE_TYPEPrimo Central Search Engine
RANK2.3686836
LOCALfalse
PrimoNMBib
record
control
sourceidproquest_cross
recordidTN_cdi_proquest_miscellaneous_1686411695
sourceformatXML
sourcesystemPC
sourcerecordid1686411695
originalsourceidFETCH-LOGICAL-c282t-2b1e23e0f379ae5dec0d7edee73c895fb2b5ceb3060a333fecff900c4db6622a3
addsrcrecordideNp9kDFPwzAQRi0EoqWwMaOMDKTYjuPEI4IClSoFIZgYIsc506DECbYz9N_jKoWR6U53T5_uHkKXBC8JzsWtG-2SYsKWmIkjNCdpmsU5z9hx6LHgMRWczdCZc18Yk4xyfopmlGPGKeNz9PEAMERro0H5pjcuktqDjVam7gfbO78F36joFYZWKujA-KgYwMqJbUxUWL_tB6gDVBjVt_3nLnoJ60C6c3SiZevg4lAX6P1x9Xb_HG-Kp_X93SZWNKc-phUBmgDWSSYkpDUoXGdQA2SJykWqK1qlCqoEcyyTJAmXai0wVqyuOKdUJgt0PeWGi79HcL7sGqegbaWBfnQl4TlnhHCRBvRmQlV4zlnQ5WCbTtpdSXC511kGneVeZxl0BvzqkDxWHdR_8K-_ANAJ2I-lMW0DFVj_f-oPJjuEHw
sourcetypeAggregation Database
isCDItrue
recordtypearticle
pqid1686411695
display
typearticle
titleDeep Infections after Endoprosthetic Replacement Operations in Orthopedic Oncology Patients
sourceAlma/SFX Local Collection
creatorDhanoa, Amreeta ; Ajit Singh, Vivek ; Elbahri, Hassan
creatorcontribDhanoa, Amreeta ; Ajit Singh, Vivek ; Elbahri, Hassan
descriptionBackground: Numerous studies have described various complications after endoprosthetic reconstructive operations. However, there are limited reports that focus specifically on deep infections (e.g., deep incisional surgical site infections), which remain one of the most dreaded complications of these operations, with rates ranging from 10% to 17%. Thus, this study was undertaken to determine the deep infection rates and to analyze possible risk factors, clinico-pathologic characteristics, and treatment modalities of endoprosthetic infections. Methods: We reviewed retrospectively the records of 105 consecutive patients who underwent endoprosthesis replacements from January 2007 to September 2011, with a minimal follow-up period of 32 mo. Comparison was made between patients with and without endoprosthetic infections. Results: Thirteen of the 150 patients (12.38%) who underwent endoprosthetic operations developed deep infections. Ninety-seven (92.4%) patients presented with a primary bone/soft tissue tumor, 5 (4.8%) with bone metastasis, and 3 (2.9%) with non-tumor conditions. Distal femoral was the most common implant location (42%). The majority of the infections (6/13) occurred within 3 mo post-operation. An elevated C-reactive protein concentration or erythrocyte sedimentation rate were present consistently in all patients at time of diagnosis, whereas clinical presentations and leukocytosis were inconsistent in determining infection. Staphylococcus aureus and coagulase-negative staphylococci (CoNS) were the most common organisms isolated, with high numbers demonstrating methicillin-resistance. Overall, multi-drug resistance was noted in 52.6% of the isolated strains. Four risk factors were associated independently with deep infection by multivariable analysis (p<0.05) and these were proximal tibia endoprosthesis, pelvic endoprosthesis, pre-operative duration of hospitalization of more than 48 h, and additional surgical procedures performed after the initial endoprosthetic insertion. Overall, infection was eradicated successfully in 53.8% (7/13) of the patients. Two-stage revision successfully treated the infection in 80% (4/5) of the patients, whereas surgical debridement without a change of implant was successful in only 42.8% (3/7) of patients. Amputation was performed in three patients. Conclusions: Patients undergoing endoprosthetic replacement for various orthopedic oncologic conditions have high infection rates. The present study allows early identification of such patients in view of the high morbidity associated with this condition. This report also highlights the high rate of multi-drug–resistant infections, especially methicillin-resistant strains of S. aureus and CoNS encountered, which complicates further the management of these patients.
identifier
0ISSN: 1096-2964
1EISSN: 1557-8674
2DOI: 10.1089/sur.2014.049
3PMID: 26046246
languageeng
publisherUnited States: Mary Ann Liebert, Inc
subjectAdolescent ; Adult ; Aged ; Aged, 80 and over ; Bacteria - drug effects ; Bacteria - isolation & purification ; Bacterial Infections - epidemiology ; Bacterial Infections - pathology ; Bone Neoplasms - surgery ; Child ; Drug Resistance, Multiple, Bacterial ; Female ; Humans ; Male ; Middle Aged ; Original Articles ; Orthopedic Procedures - adverse effects ; Reconstructive Surgical Procedures - adverse effects ; Retrospective Studies ; Soft Tissue Infections - epidemiology ; Soft Tissue Infections - pathology ; Surgical Wound Infection - epidemiology ; Surgical Wound Infection - pathology ; Young Adult
ispartofSurgical infections, 2015-06-01, Vol.16 (3), p.323-332
rights2015, Mary Ann Liebert, Inc.
lds50peer_reviewed
citesFETCH-LOGICAL-c282t-2b1e23e0f379ae5dec0d7edee73c895fb2b5ceb3060a333fecff900c4db6622a3
links
openurl$$Topenurl_article
openurlfulltext$$Topenurlfull_article
thumbnail$$Usyndetics_thumb_exl
backlink$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26046246$$D View this record in MEDLINE/PubMed
search
creatorcontrib
0Dhanoa, Amreeta
1Ajit Singh, Vivek
2Elbahri, Hassan
title
0Deep Infections after Endoprosthetic Replacement Operations in Orthopedic Oncology Patients
1Surgical infections
addtitleSurg Infect (Larchmt)
descriptionBackground: Numerous studies have described various complications after endoprosthetic reconstructive operations. However, there are limited reports that focus specifically on deep infections (e.g., deep incisional surgical site infections), which remain one of the most dreaded complications of these operations, with rates ranging from 10% to 17%. Thus, this study was undertaken to determine the deep infection rates and to analyze possible risk factors, clinico-pathologic characteristics, and treatment modalities of endoprosthetic infections. Methods: We reviewed retrospectively the records of 105 consecutive patients who underwent endoprosthesis replacements from January 2007 to September 2011, with a minimal follow-up period of 32 mo. Comparison was made between patients with and without endoprosthetic infections. Results: Thirteen of the 150 patients (12.38%) who underwent endoprosthetic operations developed deep infections. Ninety-seven (92.4%) patients presented with a primary bone/soft tissue tumor, 5 (4.8%) with bone metastasis, and 3 (2.9%) with non-tumor conditions. Distal femoral was the most common implant location (42%). The majority of the infections (6/13) occurred within 3 mo post-operation. An elevated C-reactive protein concentration or erythrocyte sedimentation rate were present consistently in all patients at time of diagnosis, whereas clinical presentations and leukocytosis were inconsistent in determining infection. Staphylococcus aureus and coagulase-negative staphylococci (CoNS) were the most common organisms isolated, with high numbers demonstrating methicillin-resistance. Overall, multi-drug resistance was noted in 52.6% of the isolated strains. Four risk factors were associated independently with deep infection by multivariable analysis (p<0.05) and these were proximal tibia endoprosthesis, pelvic endoprosthesis, pre-operative duration of hospitalization of more than 48 h, and additional surgical procedures performed after the initial endoprosthetic insertion. Overall, infection was eradicated successfully in 53.8% (7/13) of the patients. Two-stage revision successfully treated the infection in 80% (4/5) of the patients, whereas surgical debridement without a change of implant was successful in only 42.8% (3/7) of patients. Amputation was performed in three patients. Conclusions: Patients undergoing endoprosthetic replacement for various orthopedic oncologic conditions have high infection rates. The present study allows early identification of such patients in view of the high morbidity associated with this condition. This report also highlights the high rate of multi-drug–resistant infections, especially methicillin-resistant strains of S. aureus and CoNS encountered, which complicates further the management of these patients.
subject
0Adolescent
1Adult
2Aged
3Aged, 80 and over
4Bacteria - drug effects
5Bacteria - isolation & purification
6Bacterial Infections - epidemiology
7Bacterial Infections - pathology
8Bone Neoplasms - surgery
9Child
10Drug Resistance, Multiple, Bacterial
11Female
12Humans
13Male
14Middle Aged
15Original Articles
16Orthopedic Procedures - adverse effects
17Reconstructive Surgical Procedures - adverse effects
18Retrospective Studies
19Soft Tissue Infections - epidemiology
20Soft Tissue Infections - pathology
21Surgical Wound Infection - epidemiology
22Surgical Wound Infection - pathology
23Young Adult
issn
01096-2964
11557-8674
fulltexttrue
rsrctypearticle
creationdate2015
recordtypearticle
recordideNp9kDFPwzAQRi0EoqWwMaOMDKTYjuPEI4IClSoFIZgYIsc506DECbYz9N_jKoWR6U53T5_uHkKXBC8JzsWtG-2SYsKWmIkjNCdpmsU5z9hx6LHgMRWczdCZc18Yk4xyfopmlGPGKeNz9PEAMERro0H5pjcuktqDjVam7gfbO78F36joFYZWKujA-KgYwMqJbUxUWL_tB6gDVBjVt_3nLnoJ60C6c3SiZevg4lAX6P1x9Xb_HG-Kp_X93SZWNKc-phUBmgDWSSYkpDUoXGdQA2SJykWqK1qlCqoEcyyTJAmXai0wVqyuOKdUJgt0PeWGi79HcL7sGqegbaWBfnQl4TlnhHCRBvRmQlV4zlnQ5WCbTtpdSXC511kGneVeZxl0BvzqkDxWHdR_8K-_ANAJ2I-lMW0DFVj_f-oPJjuEHw
startdate20150601
enddate20150601
creator
0Dhanoa, Amreeta
1Ajit Singh, Vivek
2Elbahri, Hassan
generalMary Ann Liebert, Inc
scope
0CGR
1CUY
2CVF
3ECM
4EIF
5NPM
6AAYXX
7CITATION
87X8
sort
creationdate20150601
titleDeep Infections after Endoprosthetic Replacement Operations in Orthopedic Oncology Patients
authorDhanoa, Amreeta ; Ajit Singh, Vivek ; Elbahri, Hassan
facets
frbrtype5
frbrgroupidcdi_FETCH-LOGICAL-c282t-2b1e23e0f379ae5dec0d7edee73c895fb2b5ceb3060a333fecff900c4db6622a3
rsrctypearticles
prefilterarticles
languageeng
creationdate2015
topic
0Adolescent
1Adult
2Aged
3Aged, 80 and over
4Bacteria - drug effects
5Bacteria - isolation & purification
6Bacterial Infections - epidemiology
7Bacterial Infections - pathology
8Bone Neoplasms - surgery
9Child
10Drug Resistance, Multiple, Bacterial
11Female
12Humans
13Male
14Middle Aged
15Original Articles
16Orthopedic Procedures - adverse effects
17Reconstructive Surgical Procedures - adverse effects
18Retrospective Studies
19Soft Tissue Infections - epidemiology
20Soft Tissue Infections - pathology
21Surgical Wound Infection - epidemiology
22Surgical Wound Infection - pathology
23Young Adult
toplevel
0peer_reviewed
1online_resources
creatorcontrib
0Dhanoa, Amreeta
1Ajit Singh, Vivek
2Elbahri, Hassan
collection
0Medline
1MEDLINE
2MEDLINE (Ovid)
3MEDLINE
4MEDLINE
5PubMed
6CrossRef
7MEDLINE - Academic
jtitleSurgical infections
delivery
delcategoryRemote Search Resource
fulltextfulltext
addata
au
0Dhanoa, Amreeta
1Ajit Singh, Vivek
2Elbahri, Hassan
formatjournal
genrearticle
ristypeJOUR
atitleDeep Infections after Endoprosthetic Replacement Operations in Orthopedic Oncology Patients
jtitleSurgical infections
addtitleSurg Infect (Larchmt)
date2015-06-01
risdate2015
volume16
issue3
spage323
epage332
pages323-332
issn1096-2964
eissn1557-8674
abstractBackground: Numerous studies have described various complications after endoprosthetic reconstructive operations. However, there are limited reports that focus specifically on deep infections (e.g., deep incisional surgical site infections), which remain one of the most dreaded complications of these operations, with rates ranging from 10% to 17%. Thus, this study was undertaken to determine the deep infection rates and to analyze possible risk factors, clinico-pathologic characteristics, and treatment modalities of endoprosthetic infections. Methods: We reviewed retrospectively the records of 105 consecutive patients who underwent endoprosthesis replacements from January 2007 to September 2011, with a minimal follow-up period of 32 mo. Comparison was made between patients with and without endoprosthetic infections. Results: Thirteen of the 150 patients (12.38%) who underwent endoprosthetic operations developed deep infections. Ninety-seven (92.4%) patients presented with a primary bone/soft tissue tumor, 5 (4.8%) with bone metastasis, and 3 (2.9%) with non-tumor conditions. Distal femoral was the most common implant location (42%). The majority of the infections (6/13) occurred within 3 mo post-operation. An elevated C-reactive protein concentration or erythrocyte sedimentation rate were present consistently in all patients at time of diagnosis, whereas clinical presentations and leukocytosis were inconsistent in determining infection. Staphylococcus aureus and coagulase-negative staphylococci (CoNS) were the most common organisms isolated, with high numbers demonstrating methicillin-resistance. Overall, multi-drug resistance was noted in 52.6% of the isolated strains. Four risk factors were associated independently with deep infection by multivariable analysis (p<0.05) and these were proximal tibia endoprosthesis, pelvic endoprosthesis, pre-operative duration of hospitalization of more than 48 h, and additional surgical procedures performed after the initial endoprosthetic insertion. Overall, infection was eradicated successfully in 53.8% (7/13) of the patients. Two-stage revision successfully treated the infection in 80% (4/5) of the patients, whereas surgical debridement without a change of implant was successful in only 42.8% (3/7) of patients. Amputation was performed in three patients. Conclusions: Patients undergoing endoprosthetic replacement for various orthopedic oncologic conditions have high infection rates. The present study allows early identification of such patients in view of the high morbidity associated with this condition. This report also highlights the high rate of multi-drug–resistant infections, especially methicillin-resistant strains of S. aureus and CoNS encountered, which complicates further the management of these patients.
copUnited States
pubMary Ann Liebert, Inc
pmid26046246
doi10.1089/sur.2014.049