Fibromatosis is a benign, but locally aggressive tumour. We had a series of patients who had a high rate of recurrence though they had a wide surgical excision. The question raised was whether there are newer treatment modalities with a higher success rate. We did a retrospective study and review of the literature in order to see if there was anything new that can help us reduce recurrences. A retrospective study of all patients who presented with histologically confirmed fibromatosis at an orthopaedic practice in the past 19 years was conducted. Age of the patient at first presentation; sex; tumour site; surgery performed; histological results; first line of treatment and recurrence rate were reviewed. Patients were also contacted telephonically in order to know if they had any recurrence that was managed by another orthopaedic surgeon.Purpose of the study
Materials and Methods
The purpose of the study was to determine the normal skin flora on 30 orthopaedic patients preoperatively and to ascertain whether it changed during the patient’s stay in hospital. After ethical committee approval of the trial, on admission a swab sample was taken of the limb upon which surgery was to be performed. A postoperative swab was taken in the ward on the day of surgery. Preoperatively Staphylococcus epidermidis was cultured in 24 cases, Staphylococcus aureus in three and Enterococcus faecalis in three. Postoperatively S. epidermidis was cultured in 25 cases and Enterococcus in four. All preoperative S. epidermidis cultures were sensitive to Cloxacillin, Kefzol, Augmentin, Oflaxin and Ciprobay. Ten cases of postoperative S. epidermidis were resistant to Cloxacillin and five to Augmentin. Within 48 hours of admission, the bacterial flora with which patients were admitted changed to one that was more resistant to first-line antibiotics. We believe ‘simple’ antibiotics can be used prophylactically if the patient undergoes surgery the day of admission.
