ABSTRACT
Introduction: Periprosthetic joint infection (PJI) represents a serious burden in orthopaedic oncology. Through the years, several local expedients have been proposed to minimise the risk of periprosthetic infection. In this study, we report our outcomes using topical vancomycin powder (VP) with the aim to prevent PJIs. Materials and methods: Fifty oncological cases treated with massive bone resection and the implant of a megaprosthesis were included in our study. Among them, 22 [(GGroup A) received one gram of vancomycin powder on the surface of the implant and another gram on the surface of the muscular fascia]. The remaining 28 did not receive such a treatment (Group B). The rest of surgical procedures and the follow-up were the same for the two groups. Patients underwent periodical outpatient visits, radiographs and blood exams' evaluations. Diagnosis of PJIs and adverse reactions to topical vancomycin were recorded. Results: None of the cases treated with topical vancomycin developed infections, whereas 6 of the 28 cases (21.4%) who did not receive the powder suffered from PJIs. These outcomes suggest that cases treated with VP had a significantly lower risk of post-operative PJI (p=0.028). None of our cases developed acute kidney failures or any other complication directly or indirectly attributable to the local administration of VP. Conclusions: The topical use of vancomycin powder on megaprosthetic surfaces and the overlying fascias, alongside with a correct endovenous antibiotic prophylaxis, can represent a promising approach in order to minimise the risk of periprosthetic infections in orthopaedic oncology surgery.
Subject(s)
Brachial Plexus Neuropathies/diagnosis , Head and Neck Neoplasms/diagnosis , Neurilemmoma/diagnosis , Peripheral Nervous System Neoplasms/diagnosis , Adult , Biopsy, Needle , Brachial Plexus Neuropathies/pathology , Female , Head and Neck Neoplasms/pathology , Humans , Magnetic Resonance Imaging , Microsurgery , Neurilemmoma/pathology , Peripheral Nervous System Neoplasms/pathologySubject(s)
Jugular Veins/abnormalities , Carcinoma, Squamous Cell/surgery , Cheek , Humans , Male , Middle Aged , Mouth Mucosa , Mouth Neoplasms/surgeryABSTRACT
The facial palsy produced by a parotid tumour, could be misdiagnosed due to the absence of a palpable mass or other any signs in the computerized axial tomography or nuclear magnetic resonance. However there are data derived from the facial anatomy, course and clinical characteristics from the palsy that could make us thinking on the presence of a parotid tumour. The objective of this article is to present this characteristics, together with a serial of clinic cases which coursed in the beginning with a facial palsy and had problems in their diagnostic. It's also remarked the significance of the presence or not of perineural infiltration to the parotid tumours that will condition not only the prognosis but also the clinic course.
