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894. Patient and Surgery Characteristics on Wound Complication and Surgical Site Infection in Sarcoma Patients undergoing Hemipelvectomy

BACKGROUND: Hemipelvectomy is associated with a significant risk of wound complications, including infections, bleeding and injuries to nearby neurovascular structures as well as the gastrointestinal and genitourinary tract. This study aimed to determine the patient characteristics and approach to t...

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Autores principales: Katzman, Ju Hee, Sun, Steven, Joyce, David, Greene, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776429/
http://dx.doi.org/10.1093/ofid/ofaa439.1082
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author Katzman, Ju Hee
Sun, Steven
Joyce, David
Greene, John
author_facet Katzman, Ju Hee
Sun, Steven
Joyce, David
Greene, John
author_sort Katzman, Ju Hee
collection PubMed
description BACKGROUND: Hemipelvectomy is associated with a significant risk of wound complications, including infections, bleeding and injuries to nearby neurovascular structures as well as the gastrointestinal and genitourinary tract. This study aimed to determine the patient characteristics and approach to treatment that could affect the occurrence of surgical site infection or wound complications in sarcoma patients undergone hemipelvectomy. METHODS: We conducted a retrospective analysis of 33 adult patients who underwent hemipelvectomy at Moffitt Cancer Center, Tampa, FL, from 2008 to 2016. We used Chi-square (Exact Fisher) test to investigate the association between wound complication and categorical variables. We used a T-test to evaluate the difference in numerical variables for outcomes. RESULTS: Out of 33 patients, 12 (36.4%) patients experienced wound complications after hemipelvectomy (Table 1). The average age of patients with wound complications was 63.3 3 (57.1±15.4) years old, significantly higher than that of patients without wound complications (p=0.004). Without adjustment, the use of computer navigation had a lower wound complication rate (p=0.027). Patients with wound complications had longer hospital length of stay (14.8 vs. 7.0 days, p=0.016). Among patients with surgical site infection (Table 2), there were no patients’ characteristics or surgical characteristics associated with this outcome. Five (15%) patients developed surgical site infection and they had longer hospital stay (19.4 vs. 8.1 days, p=0.001). The organisms identified from wound cultures include methicillin-resistant Staphylococcus aureus, viridans Streptococcus, Peptostreptococcus asaccharolyticus, Enterobacter cloacae, Pseudomonas aeruginosa, Candida albicans. The organisms in late infections (more than 6 months since surgery), included above organisms plus Stenotrophomonas maltophilia and Achromobacter xylosidans. [Image: see text] [Image: see text] CONCLUSION: Older patients undergoing hemipelvectomy are at an increased risk of developing wound complications with a prolonged hospital stay. Initial antimicrobial therapy for suspected surgical site infection should include a broad-spectrum coverage to include skin and gastrointestinal flora. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-77764292021-01-07 894. Patient and Surgery Characteristics on Wound Complication and Surgical Site Infection in Sarcoma Patients undergoing Hemipelvectomy Katzman, Ju Hee Sun, Steven Joyce, David Greene, John Open Forum Infect Dis Poster Abstracts BACKGROUND: Hemipelvectomy is associated with a significant risk of wound complications, including infections, bleeding and injuries to nearby neurovascular structures as well as the gastrointestinal and genitourinary tract. This study aimed to determine the patient characteristics and approach to treatment that could affect the occurrence of surgical site infection or wound complications in sarcoma patients undergone hemipelvectomy. METHODS: We conducted a retrospective analysis of 33 adult patients who underwent hemipelvectomy at Moffitt Cancer Center, Tampa, FL, from 2008 to 2016. We used Chi-square (Exact Fisher) test to investigate the association between wound complication and categorical variables. We used a T-test to evaluate the difference in numerical variables for outcomes. RESULTS: Out of 33 patients, 12 (36.4%) patients experienced wound complications after hemipelvectomy (Table 1). The average age of patients with wound complications was 63.3 3 (57.1±15.4) years old, significantly higher than that of patients without wound complications (p=0.004). Without adjustment, the use of computer navigation had a lower wound complication rate (p=0.027). Patients with wound complications had longer hospital length of stay (14.8 vs. 7.0 days, p=0.016). Among patients with surgical site infection (Table 2), there were no patients’ characteristics or surgical characteristics associated with this outcome. Five (15%) patients developed surgical site infection and they had longer hospital stay (19.4 vs. 8.1 days, p=0.001). The organisms identified from wound cultures include methicillin-resistant Staphylococcus aureus, viridans Streptococcus, Peptostreptococcus asaccharolyticus, Enterobacter cloacae, Pseudomonas aeruginosa, Candida albicans. The organisms in late infections (more than 6 months since surgery), included above organisms plus Stenotrophomonas maltophilia and Achromobacter xylosidans. [Image: see text] [Image: see text] CONCLUSION: Older patients undergoing hemipelvectomy are at an increased risk of developing wound complications with a prolonged hospital stay. Initial antimicrobial therapy for suspected surgical site infection should include a broad-spectrum coverage to include skin and gastrointestinal flora. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7776429/ http://dx.doi.org/10.1093/ofid/ofaa439.1082 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
Katzman, Ju Hee
Sun, Steven
Joyce, David
Greene, John
894. Patient and Surgery Characteristics on Wound Complication and Surgical Site Infection in Sarcoma Patients undergoing Hemipelvectomy
title 894. Patient and Surgery Characteristics on Wound Complication and Surgical Site Infection in Sarcoma Patients undergoing Hemipelvectomy
title_full 894. Patient and Surgery Characteristics on Wound Complication and Surgical Site Infection in Sarcoma Patients undergoing Hemipelvectomy
title_fullStr 894. Patient and Surgery Characteristics on Wound Complication and Surgical Site Infection in Sarcoma Patients undergoing Hemipelvectomy
title_full_unstemmed 894. Patient and Surgery Characteristics on Wound Complication and Surgical Site Infection in Sarcoma Patients undergoing Hemipelvectomy
title_short 894. Patient and Surgery Characteristics on Wound Complication and Surgical Site Infection in Sarcoma Patients undergoing Hemipelvectomy
title_sort 894. patient and surgery characteristics on wound complication and surgical site infection in sarcoma patients undergoing hemipelvectomy
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776429/
http://dx.doi.org/10.1093/ofid/ofaa439.1082
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