Pre-Surgical Nutrition Support Reduces the Incidence of Surgical Wound Complications in Oncological Patients

The review presents results of clinical use of mTOR inhibitors, in particular, everolimus, in immunosuppressive therapy regimens. It has been established that immunosuppressive therapy regimens including mTOR inhibitors are preferred in patients with high and moderate risk of graft loss.The analysis of the clinical use of mTOR inhibitors has provided evidence of the comparative incidence rate of wound complications and terms of surgical wound healing in the treatment with everolimus and the routine therapy.Results of clinical trials have evidenced that minimization of therapy with calcineurin inhibitors and switching patients to everolimus allows for improvement of remote results of the kidney transplantation both due to reduced risk of nephrotoxic effect of calcineurin inhibitors, and due to anti-tumour and antiviral effects.

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Surgical Wound Complications after Knee Cruciate Ligament Reconstruction in Patients with Atopic Dermatitis

The Journal of Knee Surgery ◽

10.1055/s-0040-1702186 ◽

2020 ◽

Author(s):

Takuji Yokoe ◽

Takuya Tajima ◽

Nami Yamaguchi ◽

Yudai Morita ◽

Etsuo Chosa

Keyword(s):

Atopic Dermatitis ◽

Foreign Body ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Wound Complications ◽

Surgical Wound ◽

Barrier Dysfunction ◽

Suture Materials ◽

Cruciate Ligament Reconstruction ◽

Foreign Body Reactions

AbstractAtopic dermatitis (AD), sometimes referred to as eczema, is a common skin disease, and skin barrier dysfunction and immunological disorders are well recognized. However, surgical wound complications after orthopaedic surgery in patients with AD have not been described. This study aimed to report four patients with AD who developed foreign body reactions to FiberWire sutures with or without surgical wound infection (SSI) after knee cruciate ligament reconstruction (CLR). The mean age was 19.8 (range, 16–25) years, and patients 1 and 3 underwent reconstructions of the posterior and anterior cruciate ligament, respectively. At a mean of 7.5 (range, 4–10) weeks postoperatively, discharge from the surgical wound at the tibial side of the fixed graft was identified. All patients were treated with continuous saline lavage and antibiotics; however, their wounds did not heal. Second-look arthroscopy and hardware removal were performed at a mean 12.2 (range, 9–15) months postoperatively. Proliferated granulation tissue surrounding the FiberWire was identified. Intraoperative wound cultures were negative in three of the four patients. Histological examination of the tissues adjacent to the FiberWire revealed a foreign body reaction. All wounds healed immediately after the second surgery. In addition to SSI, foreign body reactions are more likely to occur in patients with AD than in those without AD. Preoperative management of AD by dermatologists and consideration of appropriate suture materials are mandatory to reduce surgical wound complications after knee CLR in patients with AD.

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Surgical wound complications after groin dissection in melanoma patients – A historical cohort study and risk factor analysis

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2014.01.019 ◽

2014 ◽

Vol 40 (10) ◽

pp. 1284-1290 ◽

Cited By ~ 34

Author(s):

M.M. Stuiver ◽

E. Westerduin ◽

S. ter Meulen ◽

A.D. Vincent ◽

O.E. Nieweg ◽

...

Keyword(s):

Factor Analysis ◽

Risk Factor ◽

Cohort Study ◽

Risk Factor Analysis ◽

Wound Complications ◽

Surgical Wound ◽

Groin Dissection ◽

Historical Cohort ◽

Historical Cohort Study ◽

Melanoma Patients

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Effect of Operative Wound Protection on Surgical Wound Complications

Journal of the Korean Gastric Cancer Association ◽

10.5230/jkgca.2007.7.4.248 ◽

2007 ◽

Vol 7 (4) ◽

pp. 248 ◽

Cited By ~ 1

Author(s):

Jin Hong Lim ◽

Sung Soo Kim ◽

Won Hyuk Choi ◽

Sung Jin Oh ◽

Woo Jin Hyung ◽

...

Keyword(s):

Wound Complications ◽

Surgical Wound ◽

Wound Protection ◽

Operative Wound

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Sirolimus appears to be associated with an increased incidence of surgical wound complications,

Reactions Weekly ◽

10.2165/00128415-200309690-00015 ◽

2003 ◽

Vol &NA; (969) ◽

pp. 5

Author(s):

&NA;

Keyword(s):

Wound Complications ◽

Surgical Wound

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The use of negative-pressure wound therapy after total knee arthroplasty is effective for reducing complications and the need for reintervention.

10.21203/rs.3.rs-21756/v1 ◽

2020 ◽

Author(s):

Camilo Partezani Helito ◽

Marcel Faraco Sobrado ◽

Pedro Nogueira Giglio ◽

Marcelo Batista Bonadio ◽

Jose Ricardo Pecora ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Postoperative Period ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Wound Complications ◽

Surgical Wound ◽

Wound Therapy ◽

Total Knee ◽

Group 1

Abstract Background: Compare the complications of patients undergoing total knee arthroplasty (TKA) who used a portable negative-pressure wound therapy (NPWT) device in the immediate postoperative period with those of a control group. Methods: A total of 296 patients were evaluated. Patients were divided into two groups: those who used NPWT for seven days in the postoperative period (Group 1) and those who used conventional dressings (Group 2). Demographic data, comorbidities, local parameters related to the surgical wound and complications were evaluated.Results: The groups did not differ in regard to sex, age and clinical comorbidities. Overall, 153 (51.7%) patients had at least one risk factor for wound complications. Patients who used NPWT had a lower rate of complications (28.5% vs. 45.7%, p = 0.001) and a lower rate of reintervention in the operating room (2% vs. 8.5%, p = 0.001). Patients in group 1 had a lower incidence of hyperaemia (14.7% vs. 40.2%, p = 0.01), skin necrosis (2.1% vs. 8.5%, p = 0.04) and wound dehiscence (3.1% vs 10.1%, p = 0.03). The use of NPWT was a protective factor for the presence of complications, with an odds ratio of 0.36 (95% CI 0.206-0.629).Conclusion: The number of complications related to the wound after TKA is high; however, most of them are minor and have no impact on the treatment and clinical evolution of patients. The use of NPWT decreased the number of surgical wound complications, especially hyperaemia, dehiscence and necrosis, and reduced the need for reintervention.

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Surgical Wound Complications after Percutaneous Posterior Pelvic Ring Fixation in Patients who Undergo Pelvic Arterial Embolization

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000001956 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Joshua D. Namm ◽

Mitchel R. Obey ◽

Sally Jo ◽

Marschall B. Berkes ◽

Christopher M. McAndrew ◽

...

Keyword(s):

Pelvic Ring ◽

Arterial Embolization ◽

Wound Complications ◽

Surgical Wound ◽

Posterior Pelvic Ring

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Skeletal muscle measurements predict surgical wound complications but not overall survival in patients with soft tissue sarcoma

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa100 ◽

2020 ◽

Vol 50 (10) ◽

pp. 1168-1174

Author(s):

Toshihide Hirai ◽

Hiroshi Kobayashi ◽

Tomotake Okuma ◽

Yuki Ishibashi ◽

Masachika Ikegami ◽

...

Keyword(s):

Skeletal Muscle ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Univariate Analysis ◽

Operating Time ◽

Risk Groups ◽

Wound Complications ◽

Surgical Wound ◽

Cart Analysis ◽

Tumour Location

Abstract Background It is unknown whether sarcopenia influences treatment outcome in patients with soft tissue sarcoma. Herein, we aimed to elucidate the impact of sarcopenia on sarcoma treatment. Methods A total of 163 soft tissue sarcoma patients were included. Skeletal muscle measures were calculated using computed tomography images. Skeletal muscle area (SMA) and density (SMD) at the L3 level were extracted, and SMA was normalized by height as skeletal muscle index (SMI). The skeletal muscle gauge (SMG) was calculated by multiplying SMD × SMI. The relationship of skeletal muscle measures and clinical factors to wound complications and prognosis was evaluated, and classification and regression tree (CART) analysis was used to develop classification models for risk groups of surgical wound complications. Results Thirty-three patients developed wound complications. In univariate analysis, age (P = 0.0022), tumour location of adductor compartment of the thigh (P = 0.0019), operating time (P = 0.010), blood loss (P = 0.030), SMD (P = 0.0004) and SMG (P = 0.0001) were significantly correlated with complications. In multivariate analysis, lower SMG was an independent risk factor (P = 0.031, OR = 3.27). CART analysis classified three risk groups of surgical wound complications by SMG, age, tumour location and operating time, and area under the receiver operating characteristic curve (AUROCC) was 0.75. SMG was not associated with prognosis in univariate analysis (P = 0.15). Conclusions The SMG does not affect overall survival but predicts surgical wound complications.

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