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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 4, issue 6
J. Bone Joint Infect., 4, 254–263, 2019
https://doi.org/10.7150/jbji.39050
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 4, 254–263, 2019
https://doi.org/10.7150/jbji.39050
© Author(s) 2019. This work is distributed under
the Creative Commons Attribution 4.0 License.

Review 15 Oct 2019

Review | 15 Oct 2019

Antimicrobial Prophylaxis for the Prevention of Surgical Site Infections in Orthopaedic Oncology - A Narrative Review of Current Concepts

Daniel Müller1, Dominik Kaiser1, Kati Sairanen2, Thorsten Studhalter3, and İlker Uçkay2,3 Daniel Müller et al.
  • 1Department of Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland
  • 2Unit of Clinical and Applied Research, Balgrist University Hospital, Zurich, Switzerland
  • 3Infectious Diseases and Infection Control, Balgrist University Hospital, Zurich, Switzerland

Keywords: orthopaedic surgery, oncology, antibiotic prophylaxis, prevention, review

Abstract. The incidence of surgical site infections (SSIs) after elective tumour orthopaedic surgery in adults is higher than non-oncologic orthopaedic surgery. Their causative microorganisms and antibiotic susceptibilities are also different from the non-oncologic cases; with no apparent predictable microbiological patterns. Clinicians continue to struggle to tailor the optimal prophylactic regimen for the very heterogeneous group of tumour patients. Many clinicians thus prolong the first-and second-generation cephalosporin agents, while a minority chooses to broaden the antimicrobial spectrum by combination prophylaxis. The variability in current practices and surgical techniques is enormous, even within the same setting. The scientific literature lacks adequate retrospective case-studies and there is currently only one prospective randomized trial. In this narrative review, we discuss various perioperative antibiotic concepts in oncologic orthopaedic surgery, including a summary of the state-to-the-art, opinions and difficulties related to the different prophylactic strategies.

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