What strategies should be implemented to minimize the risk of surgical site infection/periprosthetic joint infection (SSI/PJI) in patients who have received chemotherapy or radiation therapy and are undergoing endoprosthetic reconstruction?

Authors: João Paulo Fonseca de Freitas, Diogo Moura, Arash Aalirezaie, John Abraham,* John Strony,* Keenan Sobol*

RECOMMENDATION: We believe patients who have received either chemotherapy or radiotherapy prior to endoprosthetic reconstruction should undergo extensive medical optimization. Consideration may also be given to the use of antimicrobial coated implants, extended (>24 h) and augmented postoperative antibiotic prophylaxis consisting of a first-generation cephalosporin and an aminoglycoside and/or vancomycin, as well as use of enhanced soft tissue reconstruction techniques. Surgery should also be expeditious in these patients minimizing dissection of soft tissues with gentle handling.

LEVEL OF EVIDENCE: Limited

DELEGATE VOTE: Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)

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