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Resection of malign musculoskeletal tumors and reconstruction with large tumor prostheses often results in relevant blood loss requiring hemodynamic stabilization and transfusion.
The use of novel electrosurgical electrodes is assessed retrospectively regarding the potential to reduce blood loss and the need for transfusions.
Background Resection of malign musculoskeletal tumors and reconstruction with large tumor prostheses often result in relevant blood loss requiring hemodynamic stabilization and transfusion. Since machine autotransfusion is contraindicated in tumor surgery, other measures are necessary to reduce intraoperative blood loss.
Objectives Tungsten needle electrodes can be used to simultaneously cut skin and seal bleeding vessels for superficial dissection. Spatula electrodes coated with Teflon (polytetrafluoroethylene PTFE) are used for coagulation and dissection of deeper tissues. The coating reduces eschar build-up and thus smoke creation compared to conventional stainless-steel electrodes. This study assesses the effect of these novel electrodes on blood loss and transfusion rates.
Methods:
The investigators retrospectively investigate all cases of tumor resection and reconstruction with tumor prostheses that were operated five years before the introduction of the new electrodes (2012-2016) and five years after (2018-2021) by one single surgeon with over 25 years of experience. Data are extracted from digital patient records and analyzed by descriptive statistics and t-test for normally distributed data or Mann-Whitney test in case of non-normal distribution.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Tungsten/Teflon + | Dissection with novel electrodes (Tungsten needle electrode + Teflon coated Spatula electrode) |
| |
| Tungsten/Teflon - | Dissection without novel electrodes (Scalpel + Steel Spatula Electrode) |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Application of novel electrodes | Device | Application of novel electrodes since 2017 for the dissection of extremity tumors in tumororthopedics |
|
| Measure | Description | Time Frame |
|---|---|---|
| Blood loss | monitored during surgery in the anaesthesiology protocol | during surgery |
| Transfusion of red packed blood cells | number of intraoperative units of packed red blood cells | during surgery |
| Transfusion of red packed blood cells | number of intraoperative units of packed red blood cells | 14 days post surgery |
| Measure | Description | Time Frame |
|---|---|---|
| post surgical wound drainage | assessed via recorded volume | 5 days post surgey |
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Inclusion Criteria:
Exclusion Criteria:
- Implantation of a Megaprosthesis without history of tumor
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A defined number of cases is available. All patients with tumor resection and replacement with tumor prosthesis in the orthopedic department at UKM (2012-2016 with conventional dissection instruments and 2018-2021 with novel electrodes) from one single surgeon with over 25 years experience
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jan Puetzler, Medical doctor | Contact | 00492518359232 | jan.puetzler@ukmuenster.de | |
| Jan Puetzler, edical doctor | Contact | 00492518359232 | jan.puetzler@ukmuenster.de |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Muenster | Recruiting | Münster | North Rhine-Westphalia | 48151 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37188890 | Derived | Puetzler J, Steinbicker AU, Santel J, Deventer N, Jahn M, Zarbock A, Gosheger G, Schulze M, Jenke DJ. Blood-saving dissection with monopolar tungsten needle electrodes and Teflon-coated spatula electrodes in tumor orthopedics. J Orthop Traumatol. 2023 May 15;24(1):22. doi: 10.1186/s10195-023-00704-8. |
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No IPD will be shared
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| ID | Term |
|---|---|
| D016063 | Blood Loss, Surgical |
| D000084462 | Hyperthermia |
| ID | Term |
|---|---|
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007431 | Intraoperative Complications |
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| D001832 | Body Temperature Changes |
| D012816 | Signs and Symptoms |
| D018882 | Heat Stress Disorders |
| D014947 | Wounds and Injuries |