Rate and risk factors for wound complications after internal hemipelvectomy Journal Article

Authors: Ogura, K.; Boland, P. J.; Fabbri, N.; Healey, J. H.
Article Title: Rate and risk factors for wound complications after internal hemipelvectomy
Abstract: AIMS: Although internal hemipelvectomy is associated with a high incidence of morbidity, especially wound complications, few studies have examined rates of wound complications in these patients or have identified factors associated with the consequences. The present study aimed to: 1) determine the rate of wound and other complications requiring surgery after internal hemipelvectomy; and 2) identify factors that affect the rate of wound complications and can be used to stratify patients by risk of wound complications. METHODS: The medical records of 123 patients undergoing internal hemipelvectomy were retrospectively reviewed, with a focus on both overall complications and wound complications. Logistic regression analyses were performed to examine the association between host, tumour, and surgical factors and rates of postoperative wound complications. RESULTS: The overall rate of postoperative complications requiring surgery was 49.6%. Wound complications were observed in 34.1% of patients, hardware-related complications in 13.2%, graft-related complications in 9.1%, and local recurrence in 5.7%. On multivariate analysis, extrapelvic tumour extension (odds ratio (OR) 23.28; 95% confidence interval (CI), 1.97 to 274.67; p = 0.012), both intra- and extrapelvic tumour extension (OR 46.48; 95% CI, 3.50 to 617.77; p = 0.004), blood transfusion ≥ 20 units (OR 50.28; 95% CI, 1.63 to 1550.32; p = 0.025), vascular sacrifice of the internal iliac artery (OR 64.56; 95% CI, 6.33 to 658.43; p < 0.001), and use of a structural allograft (OR, 6.57; 95% CI, 1.70 to 25.34; p = 0.001) were significantly associated with postoperative wound complications. CONCLUSION: Internal hemipelvectomy is associated with high rates of morbidity, especially wound complications. Several host, tumour, and surgical variables are associated with wound complications. The ability to stratify patients by risk of wound complications can help refine surgical and wound-healing planning and may lead to better outcomes in patients undergoing internal hemipelvectomy. Cite this article: Bone Joint J 2020;102-B(3):280-284.
Keywords: adolescent; adult; child; preschool child; aged; child, preschool; middle aged; retrospective studies; young adult; united states; cancer staging; follow up; follow-up studies; neoplasm staging; incidence; risk factors; retrospective study; risk factor; time factors; risk assessment; pelvis tumor; pelvic neoplasms; wound dehiscence; adverse event; hemipelvectomy; time factor; surgical wound dehiscence; procedures; humans; human; male; female
Journal Title: The Bone & Joint Journal
Volume: 102-B
Issue: 3
ISSN: 2049-4394
Publisher: British Editorial Society of Bone and Joint Surgery  
Date Published: 2020-03-01
Start Page: 280
End Page: 284
Language: English
DOI: 10.1302/0301-620x.102b3.Bjj-2019-1329
PUBMED: 32114813
PROVIDER: scopus
Notes: Article -- Source: Scopus
Citation Impact
MSK Authors
  1. Patrick J Boland
    142 Boland
  2. John H Healey
    440 Healey
  3. Nicola Fabbri
    44 Fabbri
  4. Koichi Ogura
    1 Ogura