1 40 1 Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. URL Address <a href="http://doi.org/10.1016/j.injury.2007.12.002" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.injury.2007.12.002</a> Pages 411–418 Issue 4 Volume 39 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Hemipelvic amputations for recalcitrant pelvic osteomyelitis. Publisher An entity responsible for making the resource available Injury Date A point or period of time associated with an event in the lifecycle of the resource 2008 2008-04 Subject The topic of the resource 80 and over; Adult; Aged; Anti-Bacterial Agents/*therapeutic use; Cohort Studies; Female; Hemipelvectomy/*methods/psychology; Humans; Male; Middle Aged; Osteomyelitis/drug therapy/microbiology/*surgery; Palliative Care/methods; Paraplegia/psychology; Pelvic Bones/*surgery; Retrospective Studies; Secondary Prevention; Treatment Outcome; Wound Infection/*drug therapy/microbiology Creator An entity primarily responsible for making the resource Ziran Bruce H; Smith Wade R; Rao Nalini Description An account of the resource OBJECTIVE: To evaluate the outcome of recalcitrant deep pelvic infection that required a hemipelvic amputation. STUDY DESIGN: Retrospective cohort. SETTING: Tertiary referral centre; Level I trauma. PATIENTS: There were 20 patients with an infection of the pelvic girdle who developed life-threatening sepsis or had an intolerable existence due to putrefied tissues that prevented end of life care. All patients failed other more conservative treatments such as limited debridement and local wound care. The indication for amputation was life-threatening sepsis (eight patients), intolerable state with putrid tissue (four patients), and both sepsis/putrefaction (eight patients). INTERVENTION: A hemipelvic amputation, multidrug antibiotic treatment, and long-term suppression. Ten internal hemipelvectomies, eight external hemipelvectomies, and two hemicorporectomies were performed. MAIN OUTCOME MEASURE: Survival and recurrence of infection. RESULTS: Six patients died within 6 months (mean time 17 weeks, range 2-24). The 14 surviving patients had a mean follow-up time of 28 weeks (9-48). Of these, 10 patients survived with no evidence of ongoing infection, and four patients had ongoing infection requiring suppressive antibiotics. All of the six deaths were in C-hosts with an average of six comorbidities each; mean age was 62 years old. Aetiologies of the infection were vasculopathy (5), spinal cord injury (4), post fracture (3), post abdominal surgery (2), gunshot wound (2), seeding from bacteraemia (4). Cierny-Mader host class was C (11) and B systemic/local (9) with an average of four (4) comorbidities each. Mean estimated blood loss=3100 cc and operative time=157 min. There were 11 cases of minor wound problems and no flap loss. Pathogens were polymicrobial (16 total pathogens) with mean of three per patient (most common was MRSA). Multi-agent antibiotic and suppression were used in all patients. In cases with putrefied tissues, appropriate nursing care was possible. CONCLUSION: Patients requiring hemipelvectomies usually present with sepsis or an intolerable state. Despite expected complications, we found that hemipelvectomy is an effective palliative tool in selected cases. Age and vascular disease seemed to be associated with worse outcomes. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1016/j.injury.2007.12.002" target="_blank" rel="noreferrer noopener">10.1016/j.injury.2007.12.002</a> Rights Information about rights held in and over the resource Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s). 2008 80 and over Adult Aged Anti-Bacterial Agents/*therapeutic use Cohort Studies Female Hemipelvectomy/*methods/psychology Humans Injury Male Middle Aged Osteomyelitis/drug therapy/microbiology/*surgery Palliative Care/methods Paraplegia/psychology Pelvic Bones/*surgery Rao Nalini Retrospective Studies Secondary Prevention Smith Wade R Treatment Outcome Wound Infection/*drug therapy/microbiology Ziran Bruce H