title: Treatment of pelvic defect and infection with endoprosthesis exposure by topical negative pressure and irrigation with myocutaneous flap.
abstract: The treatment of wound complications and deep infection after hemipelvectomy is challenging. We describe a 17-year-old woman with Ewing sarcoma in the pelvis who underwent hemipelvectomy and reconstruction with an artificial hip joint and bone cement. After the operation, skin necrosis and deep infection with methicillin-resistant Staphylococcus aureus (MRSA) were observed. Debridement resulted in exposure of the artificial joint and bone cement. Topical negative pressure (TNP) and irrigation successfully eradicated the infection. The skin and soft-tissue defect was subsequently reconstructed using a combination of free latissimus dorsi myocutaneous flap and serratus anterior muscle flap. To our knowledge, this is the first described case of combined TNP and irrigation with myocutaneous flap for the treatment of pelvic infection and skin and soft-tissue defect with endoprosthesis exposure.
authors.affiliation: Department of Plastic Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Sei
authors.initials: S
authors.lastname: Yoshida
authors.forename: Ryohei
authors.initials: R
authors.lastname: Yokoyama
authors.forename: Akio
authors.initials: A
authors.lastname: Sakamoto
mesh_terms: D000293:Adolescent; D001843:Bone Cements; D001859:Bone Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006428:Hemipelvectomy / Q000009:adverse effects / Q000379:methods*; D006621:Hip Joint / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D018570:Risk Assessment; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply*; D013530:Surgical Wound Infection / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D001843:Bone Cements