XXXX COATED PROSTHESIS IN ONCOLOGICAL LIMB SALVAGE SURGERY REDUCE THE INFECTION RATE.

@entity1 @entity137 @entity3478 @entity5 @entity575 @entity281
@entity575 coatings, used in many surgical devices, have demonstrated good antimicrobial activity and low @entity137 . Oncological musculoskeletal surgery have a high risk of @entity281 , so in the last decades, @entity575 -coated mega-prostheses have been introduced and are becoming increasingly widespread. In this study, a retrospective analysis of 158 cases of @entity3478 , primary or metastatic, treated between 2005- 2015 with wide margins resection and @entity5 implants reconstruction, was performed. The average age was 59 years (range 11-78 years), the same surgeon with antibiotic prophylaxis according to a standard protocol treated all @entity1 . @entity575 -coated prostheses were implanted in 58.5% of @entity1 and uncoated @entity5 prostheses in the remaining 41.5%. @entity1 were re-evaluated annually and complications were recorded, focusing analysis on infective complications. The average follow-up was 39.7 months: 23.4% of @entity1 died at a median time of 35.3 months after surgery; 18.4% developed complications that required new surgery, of which 12.6% of these were due to @entity281 . @entity1 treated with @entity575 -coated implants developed @entity281 in 2.2% of cases against the 10.7% of the @entity1 treated with standard @entity5 prosthesis. This difference between the two groups was statistically significant. The percentage of late infections occurring from 6 months after surgery was similar in both groups. @entity575 blood level taken in a sample of @entity1 at different times after surgery, always showed values well below the threshold of @entity137 and no @entity1 showed any sign of local or general @entity137 secondary to @entity575 . Our study demonstrates that @entity5 @entity575 -coated implants have a rate of @entity281 significantly lower than traditional implants, while there were no differences in the rate of late infections as described also in the literature. We recommend the use of @entity575  coated prosthesis as primary implants for limb salvage surgery in primary or metastatic @entity3478 , considering the absence of @entity137 and the lower rate of @entity281 .
