Surgical management of XXXX .

@entity1 @entity6 @entity177 @entity281 @entity158 @entity734
OBJECTIVE: @entity281 are rarely encountered and their management is not well standardised. We reviewed our experience with the management of this condition in order to evaluate the role of surgery in the management of the @entity281 and to provide an algorithm for its treatment. METHODS: It is a multicentre study in which we retrospectively reviewed the data files of the @entity1 who were referred to us for surgical management of @entity281 . RESULTS: From March 2003 to June 2009, 14 @entity1 (12 @entity1 and two @entity1 ) were treated surgically for infected SCJ. No @entity1 were found in the paediatric age group. Mean age was 49.8 years with a range between 26 and 77 years. All @entity1 were symptomatic. The prevalent symptom was either anterior chest wall swelling (21%) or @entity158 (29%); while 50% of them presented with both swelling and @entity158 . Associated risk factors were elicited in 12 @entity1 (86%) while it could not be identified in two @entity1 (14%). These risk factors were in the form of @entity734 in three @entity1 , @entity6 ( @entity6 ) in four, @entity177 ( @entity177 ) in three @entity1 and two @entity1 had both @entity6 and @entity177 . Surgical management was performed in all @entity1 in the form of either incision and drainage in two @entity1 (14%); or SCJ curettage in three @entity1 (21%), while resection of the SCJ was done in nine @entity1 (62%). Mean postoperative hospital stay period (PHS) was 8.1 days (range: 5-30 days). All of them are alive and free of symptoms in follow-up. CONCLUSION: Surgery was found to be curative with good results for those @entity1 with @entity281 that did not respond to a full course of intravenous antibiotic therapy. Surgical options include incision and drainage, curettage or SCJ resection. The type of surgical procedure depends on the radiological findings, presentation, severity of the @entity281 and intra-operative findings. In our experience, complex muscle flap reconstruction was not necessary following SCJ resection.
