Local Antibiotic Administration Decreases Surgical Site Infections Following Extremity Sarcoma Surgery.

Background and objectives: The morbidity associated with the treatment of extremity sarcoma resection is significant, and surgical site infection (SSI) remains a prevalent concern. This cohort study compares the outcomes of patients who received local, intra-wound antibiotic powder with those who did not during the resection of extremity sarcomas.

Methods: This study included 83 patients. Of these, 25 (30%) patients had received local vancomycin and/or tobramycin antibiotic powder just before wound closure, while 58 (70%) underwent routine closure without administration of local antibiotics. Patient demographics, tumor characteristics, and surgical characteristics were collected.

Results: The local antibiotic group consisted of larger tumors (11.50 ± 7.65 vs. 7.79 ± 5.27 cm; p = 0.038) undergoing longer surgeries (594 ± 323 vs. 360 ± 285 min; p = 0.003) with more estimated blood loss (426 ± 399 vs. 177 ± 539 mL; p = 0.023). The postoperative SSI rate was lower in the antibiotic group at 16% versus 40% in the no antibiotic group (p = 0.043). When accounting for possible confounders, the odds ratio of SSI in the antibiotic group versus no antibiotic group was 0.0747 [0.00882, 0.404] (p = 0.0075).

Conclusion: Despite the significantly greater tumor burden in the antibiotic group, this study suggests an effective role for local antibiotic powder administration in the prevention of postoperative infections in extremity sarcoma surgery.