Guidelines for Complications of Cancer Treatment Vol VIII Part B

Infection in Limb Salvage Surgery :Incidence, Treatment and Diagnosiss.Evidence Based GuidelinesThe IncidenceInfection is a serious complication after Endoprostheticreconstruction. It often leads to amputation and retards orcontraindicates postoperative chemotherapy. The infection ratein the literature varies widely, ranging from 2% to 40% 1-10 .This incidence of infection after tumor resection and limbsalvage surgery, by endoprosthesis or allograft, is much higherthan after conventional orthopaedic surgery. This is notunexpected as these patients have longer operations, there is alarge amount of tissue exposed at the time of surgery, and theyfrequently are immuno-compromised as a result of neoadjuvantchemotherapy. Results using endoprostheses have showninfection rates varying from none in the humerus to 33% inthe proximal tibia 11-14 . The highest infection rates occur afterproximal tibial reconstruction and in children who havefrequent lengthening procedures. The overall infection rate inmore than 650 patients with long-term follow-up was9.6% 11-15 . The inexperienced surgeon may have a higherincidence of wound complications in the early learning course.106