ArticleBMC surgery2021
Multidisciplinary team meetings for patients with complex extremity defects: a retrospective analysis of treatment recommendations and prognostic factors for non-implementation.
Article in BMC surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- The application of robot-assisted microsurgery in orthoplastic surgery.Innovative surgical sciences · 2026Article
- [Analyzing the multidisciplinary strategies for diagnosis and treatment of patients with burns and trauma from a management perspective].Zhonghua shao shang yu chuang mian xiu fu za zhi · 2025Article
- Implementation of multidisciplinary team decisions on the management of complex bone and joint infections: an observational study.BMC musculoskeletal disorders · 2025Observational
- Hands-On Robotic Microsurgery: Robotic-Assisted Free Flap Reconstruction of the Upper Extremity.Journal of clinical medicine · 2024Article
- Presentation and multidisciplinary management of a unique case of lower limb dysmelia resulting from amniotic band syndrome.BMJ case reports · 2024Article
- The Value of a Co-surgeon in Microvascular Breast Reconstruction: A Systematic Review and Meta-analysis.Plastic and reconstructive surgery. Global open · 2024Article
- Microsurgical Strategies after Free Flap Failure in Soft Tissue Reconstruction of the Lower Extremity: A 17-Year Single-Center Experience.Journal of personalized medicine · 2022Article
- An Algorithm for Elective Amputation Combined with Targeted Muscle Reinnervation in Complex Regional Pain Syndrome-A Perspective.Journal of personalized medicine · 2022Article
- The role of multidisciplinary teams in musculoskeletal infection.Bone & joint research · 2022Article
- The impact of a multidisciplinary team on the management of fracture-related infections: A surveillance study in Brazil.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
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7 authors.
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Abstract
backgroundThis study aimed to assess a multidisciplinary team (MDT) meeting approach for the management of patients with complex extremity defects, analyze treatment recommendations, and evaluate factors influencing non-implementation.
methodsAll patients introduced to an MDT meeting for complex extremity defects from 2015 to 2017 were included in a retrospective cohort study. Patients' characteristics and defect causes were evaluated. Treatment recommendations (TR) of MDT meetings and subsequent implementation were reviewed (cohort with implementation of TR versus cohort with non-implementation of TR), and factors associated with non-adherence to recommendations were statistically analyzed using logistic regression.
resultsFifty-one patients (41 male) with a mean age of 54 years were presented in 27 MDT meetings. Most of the patients (70%) suffered from reconstructive challenging or combined bone- and soft tissue defects, primarily located at the lower extremity (88%). Large skeletal defects, chronic osteomyelitis, and multi-fragmented fractures were present in 65% of cases. Forty-five percent of the patients suffered from peripheral vascular disease, necessitating surgical optimization. Of the 51 MDT decisions, 40 were implemented (78%; (32/40) limb salvage versus 22%; (8/40) limb amputation). Limb salvage was successfully achieved in 91% (29/32) of the cases. Failed limb salvages were due to flap failure (33%; 1/3), recurring periprosthetic joint infections (66%; 2/3) and concomitant reconstructive failure. Patients who underwent limb amputation, as recommended, showed proper stump healing and regained mobility with a prosthesis. Overall the MDT treatment plan was effective in 92.5% (37/40) of the patients, who adhered to the MDT treatment recommendation. In eleven patients (22%; 11/51), the MDT treatment was not implemented. MDT decisions were less likely to be implemented, if amputation was recommended (p = 0.029).
conclusionsMDT meetings represent a valid tool to formulate individualized treatment plans, avoiding limb amputation in most patients with severe extremity defects. Recommendation for limb amputation is less likely to be implemented than plans for limb salvage.
trial registrationRetrospectively registered.
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