This study is for patients that have suffered a femur fracture due to metastatic cancer. The standard of care for this type of fracture is to stabilize the bone with an intramedullary nail. When preparing the femur for the nail, pressure can cause fat to enter the bloodstream and travel to the heart, causing heart and lung complications. The procedure being investigated in this study is called reduced pressure reaming. In this procedure the surgeon will use a device with suction when preparing the bone for the nail in order to decrease pressure and decrease the amount of fat that enters the bloodstream. Patients will be randomly assigned to either the standard preparation (standard reaming), or the reduced pressure preparation (reduced pressure reaming). After surgery, both treatment groups will followed according to standard practices at 2 weeks, 6 weeks, 3 months, and 6 months.
Roughly half of patients who have sarcoma surgery with preoperative radiation have wound complications after surgery. This goal of this study is to look at the levels of oxygen in the skin before and after surgery and compare them to the wound outcome. The information gained could lead to a change in surgical practices.
This is a study comparing two methods of dressing a post operative wound that are currently in practice. One method is a traditional dry gauze dressing. The other method is using a negative pressure dressing that provides gentle suction on the wound.
We will attempt to determine how well the use of post-operative negative pressure dressing reduces wound healing problems in patients who have surgery after radiation for a sarcoma in the thigh or leg.