Extensive Tissue Damage Research Articles

Microsurgical vascular suture

Anastomosis of two vessels by end-to-end or end-to-side suturing to create an uninterrupted blood flow between the two vessels. Transplantations; replantations; vascular trauma. Active infections in the area to be vascularized or surgical site; large differences in caliber between the vessels; hypercoagulability; extensive tissue damage. First, clamping, cleaning and flushing of the vessel ends; adaptation of the vessel ends using end-to-end or end-to-side anastomosis, using an end-to-side anastomosis if an existing vessel axis should not be interrupted; creation of the anastomosis using asingle button suture or continuous suture technique; careful avoidance of puncturing the posterior wall and exact adaptation of the vessel ends without leaks; release of the blood flow and examination of the anastomosis. Postoperative avoidance of traction, tension, pressure and shear forces on the anastomosis; regular blood flow checks of the revascularized tissue or flap; sufficient anticoagulation. An atraumatic and gentle suturing technique is abasic requirement for asuccessful anastomosis. Special suturing techniques can improve the anastomosis of fragile vessels.

Accidental High Voltage Electrocution Leading To Abdominal Wall Blow Out With Omental Evisceration And Auto Amputation Of Right Upper Limb: An Unusual Presentation

Electricity is the backbone for modern industrialization, development and day to day needs. Electrical Injuries are among the most devastating of burn injuries. High voltage electrical injuries result in extensive deep tissue damage and are associated with multiple complications and a high mortality rate. The passage of electric current through the body, produces wide range of effects, varying from insignificant localised spasm, little or no contact burns, or extreme severe burns. We describe the case of a 6-year-old child who suffered high voltage electric injury leading to anterior abdominal wall blow out with omental evisceration and auto amputation of right forearm. He was initially resuscitated in emergency room followed by emergency exploratory laparotomy was done with primary repair of ileal perforation along with right arm 4 quadrant amputation. This paper also emphasizes the safety measures to be taken at work place pertaining to high voltage cable

Development of a porcine model of skin and soft-tissue infection caused by Staphylococcus aureus, including methicillin-resistant strains suitable for testing topical antimicrobial agents.

In view of the ever-increasing representation of Staphylococcus spp. strains resistant to various antibiotics, the development of invivo models for evaluation of novel antimicrobials is of utmost importance. In this article, we describe the development of a fully immunocompetent porcine model of extensive skin and soft tissue damage suitable for testing topical antimicrobial agents that matches the real clinical situation. The model was developed in three consecutive stages with protocols for each stage amended based on the results of the previous one. In the final model, 10 excisions of the skin and underlying soft tissue were created in each pig under general anesthesia, with additional incisions to the fascia performed at the base of the defects and immediately inoculated with Staphylococcus aureus suspension. One pig was not inoculated and used as the negative control. Subsequently, the bandages were changed on Days 4, 8, 11, and 15. At these time points, a filter paper imprint technique (FPIT) was made from each wound for semi-quantitative microbiological evaluation. Tissue samples from the base of the wound together with the adjacent intact tissue of three randomly selected defects of each pig were taken for microbiological, histopathological, and molecular-biological examination. The infection with the inoculated S. aureus strains was sufficient during the whole experiment as confirmed by both FPIT and from tissue samples. The dynamics of the inflammatory markers and clinical signs of infection are also described. A successfully developed porcine model is suitable for invivo testing of novel short-acting topical antimicrobial agents.

Clinical and immunological characteristics of COVID-19 in patients with disease dynamics

The aim is to study the clinical and immunological indicators of COVID-19 in the dynamics of the disease with the determination of predictors of the development of changes in the lungs. Materials and methods. The object of the study was 35 patients aged 22 to 75 years in the acute period and dynamics of COVID-19 disease, divided into two groups according to the identified clinical and immunological disorders. Markers of cellular (CD-3, CD-4, CD-8, CD-19) and humoral immunity, cytokines (IL-6,8, TGF-β, TNF-α), CEC were determined in all examined patients. Statistical processing of the obtained results was carried out using the computer program Statistica 10.0. Results. It was found that all the subjects retained clinical and immunological changes during the entire follow-up period, which indicates an ongoing disease. At the same time, significant differences in the severity of changes in individuals were revealed, taking into account age and the presence of chronic somatic pathology, expressed primarily in violation of the parameters of the T-system of immunity. In patients with the development of postcovoid changes in the lungs, characteristic immunological features were revealed, taking into account age. Conclusions. A violation of the detected indicators of the immune system may indicate the persistence of the virus, which means a prolongation of a specific inflammatory response with the risk of extensive tissue damage. Within three months after recovery, the tendency towards the formation of humoral immunity persists in both groups, which occurs by the end of 1 month after the disease in both groups and continues throughout the entire follow-up period. In the risk group for the development of pneumofibrosis in the outcome of a new coronavirus infection, the combination of IL-8 and TGF-β is the most optimal, despite their significant decrease in dynamics compared with the acute period.

Acute Corrosive Acid Ingestion: A Case Series of Four Autopsies

Acute corrosive acid ingestion presents significant challenges in clinical and forensic pathology due to its severe and often fatal outcomes. This case series examines four autopsies involving fatal acid ingestion: three cases of hydrochloric acid (HCl) poisoning and one case of sulfuric acid (H₂SO₄) poisoning. Each case provides detailed autopsy findings, focusing on macroscopic and microscopic pathological changes. The first three cases of HCl poisoning revealed extensive tissue damage characterized by coagulative necrosis, particularly affecting the esophagus, stomach, and duodenum. Histological examination showed dense inflammatory infiltrate, submucosal edema, and significant hemorrhage, with patchy necrosis observed in the liver and kidneys. Pulmonary findings included alveolar edema and hemorrhage. The fourth case, involving H₂SO₄ ingestion, demonstrated more severe injuries with transmural necrosis and extensive hemorrhagic infiltration in the esophagus. The stomach exhibited full-thickness necrosis with a pronounced sulfurous odor, indicating severe chemical injury. Histopathological findings included extensive tissue dehydration and charring, with severe alveolar edema and hemorrhage in the lungs and extensive necrosis in the liver and kidneys. Comparative analysis of the histopathological changes highlighted the differences in tissue damage caused by these two acids. HCl primarily induced superficial necrosis with relatively preserved tissue architecture, while H₂SO₄ caused more extensive and deeper tissue damage due to its strong dehydrating and exothermic properties. Recognizing these differences is crucial for forensic pathologists in accurately diagnosing and differentiating cases of acid poisoning, ultimately enhancing diagnostic precision and clinical outcomes. This study underscores the severe and often fatal consequences of acute acid ingestion and aims to enhance the understanding of the pathological changes associated with such poisonings, thereby improving forensic and clinical evaluations.

Unveiling advanced strategies for therapeutic stem cell interventions in severe burn injuries: a comprehensive review.

This comprehensive review explores the complex terrain of stem cell therapies as a potential therapeutic frontier in the healing of complicated burn wounds. Serious tissue damage, impaired healing processes, and possible long-term consequences make burn wounds a complex problem. An in-depth review is required since, despite medical progress, existing methods for treating severe burn wounds have significant limitations. Burn wounds are difficult to heal because they cause extensive tissue damage. The challenges of burn injury-induced tissue regeneration and functional recovery are also the subject of this review. Although there is a lot of promise in current stem cell treatments, there are also some limitations with scalability, finding the best way to transport the cells, and finding consistent results across different types of patients. To shed light on how to improve stem cell interventions to heal severe burn wounds, this review covers various stem cell applications in burn wounds and examines these obstacles. To overcome these obstacles, one solution is to enhance methods of stem cell distribution, modify therapies according to the severity of the burn, and conduct more studies on how stem cell therapy affects individual patients. Novel solutions may also be possible through the combination of cutting-edge technologies like nanotechnology and biotechnology. This review seeks to increase stem cell interventions by analyzing present challenges and suggesting strategic improvements. The goal is to provide a more effective and tailored way to repair serious burn wounds.

9-HODE associates with thalamic atrophy and predicts white matter damage in multiple sclerosis

BackgroundMultiple sclerosis (MS) is characterized by extensive tissue damage leading to a range of complex symptoms, including physical disability and cognitive dysfunction. Recent work has indicated the clinical relevance of bioactive lipid mediators (LMs), which are known to orchestrate inflammation and its resolution and are deregulated in MS. However, it is unknown whether LM profiles relate to white matter (WM) damage. ObjectivesTo investigate the potential association between plasma-derived LMs and MRI-quantified WM damage using fractional anisotropy (FA) and grey matter (GM) atrophy in dimethyl fumarate-treated relapsing remitting MS (RRMS) patients. MethodsSeverity of FA-based WM damage and GM atrophy was determined in RRMS patients (n=28) compared to age- and sex-matched controls (n=31) at treatment initiation (baseline) and after 6 months. Plasma LMs were assessed using HPLC-MS/MS and baseline LMs were correlated to changes in FA and brain volumes. ResultsWe observed significant WM damage in RRMS patients (mean age 41.4 [SD 9.1]) at baseline and follow-up (z-score=-0.33 and 0.31, respectively) compared to controls (mean age 41.9 [SD 9.5]; p<0.001 for both comparisons). Patients with severe WM damage showed a decline of thalamic volume (p=0.02), and this decline correlated (r=0.51, p<0.001) with lower baseline levels of 9-HODE. This LM also predicted FA worsening (beta=0.14, p<0.001) over time at 6 months. ConclusionDespite the relatively small sample size, lower baseline levels of the LM 9-HODE correlated with more thalamic atrophy and predicted subsequent worsening of WM damage in RRMS patients.

Salvage of a comminuted proximal tibial polymicrobial infected non-union with antibiotic loaded bio-composite and intramedullary nailing: a case report

Background. Management of open proximal metaphyseal fractures poses a significant challenge and is fraught with complications. These injuries are severe, often accompanied by extensive soft tissue and vascular damage, leading to high risks of infection and long-term disability. Case presentation. A 72-year-old male was severely injured in a road traffic accident. Plain X-rays and CT angiogram identified a comminuted proximal tibial fracture with transection of the popliteal artery and vein. Initial emergency treatment included fasciotomies, external fixation, and vascular primary repair. On the 12th day of admission, the patient underwent open reduction and internal fixation (ORIF) with dual plate fixation using a two incision technique. A plastic surgeon performed skin grafting, harvested from the patient’s thigh, to allow closure of his fasciotomy wounds immediately following ORIF. Four weeks post-operatively, the patient developed a wound breakdown over the lateral fasciotomy site, exposing the metal plates with a small defect developing on the medial fasciotomy wound in tandem. The patient’s course was further complicated by persistent polymicrobial infections. Over 6 months of antibiotic regimes, operative intervention was ultimately required. All of the infected metal implants were removed, the non-union sites were aggressively debrided. The tibial canal was reamed to prepare for a tibial nailing. An antibiotic loaded bio-composite was then inserted through the non-union sites into the canal followed by an intramedullary nail. A blocking screw was used to address the procurvatum deformity in the sagittal plane. The patient currently shows signs of recovery, mobilizing over short distances, weight-bearing with assistive aids and with healing wounds and early signs of callus formation on recent CT scans and plain X-rays. Conclusions. The management of complex tibial fractures with vascular involvement demands an aggressive multidisciplinary approach and continuous adaptability in treatment plans to address the evolving challenges of such severe injuries. This case exemplifies the utility of injectable antibiotic-loaded bio-composites in a limb-salvage setting and their ability to provide high doses of local antibiotics to an infection site which, in conjunction with appropriate stable fixation and systemic antibiotics, can aid in eradicating and treating fracture-related infections.

Understanding the Impact: Insect Pests of Millets and their Consequences on Yield Loss

Millets, crucial cereal crops in many regions, face significant threats from various insect pests, leading to substantial yield losses. Insect pests such as stem borers, leaf folders, aphids, midges, bugs, caterpillars, and termites inflict damage at different growth stages of millet plants. Stem borers like Chilo partellus and Sesamia inferens bore into stems, impairing structural integrity, while leaf folders such as Cnaphalocrocis medinalis create folded leaf shelters for feeding, causing extensive tissue damage. Aphids such as Rhopalosiphum maidis and shoot bugs like Peregrinus maidis extract sap, resulting in wilting and stunting of plants. Millet midges like Geromyia penniseti and Stenodiplosis sorghicola target reproductive structures, leading to grain abortion and reduced yield. Earhead pests like Cryptoblabes gnidiella and Helicoverpa armigera feed on developing grains, causing significant losses in quality and quantity. Additionally, termites like Odontotermes spp. and Microtermes spp. damage roots and stems, disrupting nutrient and water uptake causing plant death. Understanding the biology and ecology and implementing appropriate pest management strategies are crucial for mitigating yield losses and ensuring millet production sustainability.

Novel Models for Assessing and Pathophysiology of Hepatic Ischemia-Reperfusion Injury Mechanisms.

Hepatic ischemia-reperfusion injury (IRI) is a major cause of postoperative hepatic dysfunction and liver failure involving cellular damage to previously ischemic tissues to which blood flow is restored. The reestablishment of blood flow is essential for salvaging ischemic tissues. The reperfusion itself, however, can paradoxically lead to further cellular damage, which involves a multi-factorial process resulting in extensive tissue damage, which can threaten the function and viability of the liver and other organ systems. The following review outlines multiple models for in-lab analysis of the various hepatic IRI mechanisms, including murine, porcine, cell lines, and machine perfusion models.

Minimally Invasive Surgery: A Paradigm Shift in Surgical Procedures

Minimally Invasive Surgery (MIS) and microsurgery have significantly transformed periodontal treatment by reducing tissue trauma and improving patient outcomes. MIS focuses on minimizing flap reflection and tissue manipulation, preserving blood supply, and ensuring the stability of blood clots at the wound site, which collectively reduce postoperative complications such as shrinkage and discomfort. Microsurgery, enabled by advancements in surgical microscopes, enhances visual acuity and allows for precise surgical interventions. In periodontology, the integration of MIS and microsurgery has led to refined surgical techniques that prioritize minimal tissue disruption, passive wound closure, and the use of specialized microsurgical instruments. These approaches offer significant advantages over conventional flap surgeries, which were often associated with extensive tissue damage, prolonged healing times, and aesthetic compromises. The evolution of MIS in periodontology represents a shift from resection-based procedures to those focused on regeneration, emphasizing the importance of skill enhancement and the adoption of advanced technologies. As MIS techniques continue to develop, they hold the potential to become the standard of care, providing patients with effective, less invasive treatment options that result in better clinical and aesthetic outcomes. The current article's goal was to gather and record different minimally invasive periodontology techniques. Peer-reviewed materials from journals, Medline/PubMed, Google Scholar, and other reviews served as the foundation for the research.

High-Voltage Electrical Burn Requiring Urgent Scalp Reconstruction after Developing a Brain Abscess

Electrical burn injuries to the scalp are at risk of extensive tissue damage and neurological complications. We present the case of a patient who came into contact with a high-voltage power line while cherry picking, resulting in a large full-thickness scalp defect. Early on in his presentation, he developed progressive global weakness which remained relatively static during his admission. An incidental finding of an extradural abscess complicated his management, requiring urgent surgical intervention with definitive tissue coverage. The scalp was reconstructed using a free myocutaneous anterolateral thigh flap. There were no postoperative complications. Following rehabilitation, the patient was discharged home with limited functional recovery. He mobilises independently with a wheelchair and requires full-time carers.

Necrotizing soft tissue infections

Necrotizing soft tissue infections are aheterogeneous group of severe infections of the skin, connective tissue and muscles in which necrotic destruction of the tissue occurs at the site of infection. Various bacteria are known as "typical" triggering pathogens and the infection can occur on the entire surface of the body. Necrotizing soft tissue infections are always atime-sensitive emergency associated with high mortality. Many affected patients are critically ill and require treatment in an intensive care unit. The rapid and radical surgical treatment is an essential part of management and in addition an adequate and timely antimicrobial treatment is of great importance. The health consequences for surviving patients are often severe, as extensive soft tissue damage leads to functional impairments. In many cases extensive plastic surgery follow-up is necessary. Therefore, necrotizing soft tissue infections are "complicated" in every phase of the disease and require interprofessional treatment. This review article provides a current overview of various aspects of the diagnostics, treatment and aftercare of necrotizing soft tissue infections.

Neutrophil extracellular traps characterize caseating granulomas

Tuberculosis (TB) remains one of the top 10 causes of death worldwide and still poses a serious challenge to public health. Recent attention to neutrophils has uncovered unexplored areas demanding further investigation. Therefore, the aim of this study was to determine neutrophil activation and circulatory neutrophil extracellular trap (NET) formation in various types of TB. Sera from TB patients (n = 91) and healthy controls (NHD; n = 38) were analyzed for NE-DNA and MPO–DNA complexes, cell-free DNA (cfDNA), and protease activity (elastase). We show that these NET parameters were increased in TB sera. Importantly, NET formation and NE activity were elevated in TB patients with extensive tissue damage when compared to those with minor damage and in patients with relapse, compared to new cases. We discuss the importance of balancing NET formation to prevent tissue damage or even relapse and argue to analyze circulating NET parameters to monitor the risk of disease relapse. To investigate the tissues for NETs and to find the source of the circulating NET degradation products, we collected sections of granulomas in lung and lymph node biopsies. Samples from other diseases with granulomas, including sarcoidosis (SARC) and apical periodontitis (AP), served as controls. Whereas NET formation characterizes the caseating granulomas, both caseating and non-caseating granulomas harbor DNA with unusual conformation. As TB is associated with hypercoagulation and thromboembolism, we further imaged the pulmonary vessels of TB patients and detected vascular occlusions with neutrophil aggregates. This highlights the dual role of neutrophils in the pathology of TB.

Breaking the Cycle: Matrix Metalloproteinase Inhibitors as an Alternative Approach in Managing Tuberculosis Pathogenesis and Progression.

Mycobacterium tuberculosis (Mtb) has long posed a significant challenge to global public health, resulting in approximately 1.6 million deaths annually. Pulmonary tuberculosis (TB) instigated by Mtb is characterized by extensive lung tissue damage, leading to lesions and dissemination within the tissue matrix. Matrix metalloproteinases (MMPs) exhibit endopeptidase activity, contributing to inflammatory tissue damage and, consequently, morbidity and mortality in TB patients. MMP activities in TB are intricately regulated by various components, including cytokines, chemokines, cell receptors, and growth factors, through intracellular signaling pathways. Primarily, Mtb-infected macrophages induce MMP expression, disrupting the balance between MMPs and tissue inhibitors of metalloproteinases (TIMPs), thereby impairing extracellular matrix (ECM) deposition in the lungs. Recent research underscores the significance of immunomodulatory factors in MMP secretion and granuloma formation during Mtb pathogenesis. Several studies have investigated both the activation and inhibition of MMPs using endogenous MMP inhibitors (i.e., TIMPs) and synthetic inhibitors. However, despite their promising pharmacological potential, few MMP inhibitors have been explored for TB treatment as host-directed therapy. Scientists are exploring novel strategies to enhance TB therapeutic regimens by suppressing MMP activity to mitigate Mtb-associated matrix destruction and reduce TB induced lung inflammation. These strategies include the use of MMP inhibitor molecules alone or in combination with anti-TB drugs. Additionally, there is growing interest in developing novel formulations containing MMP inhibitors or MMP-responsive drug delivery systems to suppress MMPs and release drugs at specific target sites. This review summarizes MMPs' expression and regulation in TB, their role in immune response, and the potential of MMP inhibitors as effective therapeutic targets to alleviate TB immunopathology.

Essential role of p21Waf1/Cip1 in the modulation of post-traumatic hippocampal Neural Stem Cells response

BackgroundTraumatic Brain Injury (TBI) represents one of the main causes of brain damage in young people and the elderly population with a very high rate of psycho-physical disability and death. TBI is characterized by extensive cell death, tissue damage and neuro-inflammation with a symptomatology that varies depending on the severity of the trauma from memory loss to a state of irreversible coma and death. Recently, preclinical studies on mouse models have demonstrated that the post-traumatic adult Neural Stem/Progenitor cells response could represent an excellent model to shed light on the neuro-reparative role of adult neurogenesis following damage. The cyclin-dependent kinase inhibitor p21Waf1/Cip1 plays a pivotal role in modulating the quiescence/activation balance of adult Neural Stem Cells (aNSCs) and in restraining the proliferation progression of progenitor cells. Based on these considerations, the aim of this work is to evaluate how the conditional ablation of p21Waf1/Cip1 in the aNSCS can alter the adult hippocampal neurogenesis in physiological and post-traumatic conditions.MethodsWe designed a novel conditional p21Waf1/Cip1 knock-out mouse model, in which the deletion of p21Waf1/Cip1 (referred as p21) is temporally controlled and occurs in Nestin-positive aNSCs, following administration of Tamoxifen. This mouse model (referred as p21 cKO mice) was subjected to Controlled Cortical Impact to analyze how the deletion of p21 could influence the post-traumatic neurogenic response within the hippocampal niche.ResultsThe data demonstrates that the conditional deletion of p21 in the aNSCs induces a strong increase in activation of aNSCs as well as proliferation and differentiation of neural progenitors in the adult dentate gyrus of the hippocampus, resulting in an enhancement of neurogenesis and the hippocampal-dependent working memory. However, following traumatic brain injury, the increased neurogenic response of aNSCs in p21 cKO mice leads to a fast depletion of the aNSCs pool, followed by declined neurogenesis and impaired hippocampal functionality.ConclusionsThese data demonstrate for the first time a fundamental role of p21 in modulating the post-traumatic hippocampal neurogenic response, by the regulation of the proliferative and differentiative steps of aNSCs/progenitor populations after brain damage.

Modified reverse Hughes technique for upper eyelid reconstruction – Case report

Patients with scarring in the eyelids present a significant surgical challenge, particularly when the scarring results from severe trauma. This case report describes a young female patient with a history of keloid formation who sustained an upper eyelid trauma, resulting in extensive tissue avulsion and damage to the upper canaliculus. An upper eyelid reconstruction was undertaken using the tarsoconjunctival flap advancement procedure (modified reverse Hughes) for both the lower and upper eyelids to reconstruct the defect. This reconstruction facilitated anatomic and functional recovery, including eyelid opening and closing, and appearance.

The Lung in Rheumatoid Arthritis-Friend or Enemy?

Rheumatoid arthritis (RA) is a chronic autoimmune condition frequently found in rheumatological patients that sometimes raises diagnosis and management problems. The pathogenesis of the disease is complex and involves the activation of many cells and intracellular signaling pathways, ultimately leading to the activation of the innate and acquired immune system and producing extensive tissue damage. Along with joint involvement, RA can have numerous extra-articular manifestations (EAMs), among which lung damage, especially interstitial lung disease (ILD), negatively influences the evolution and survival of these patients. Although there are more and more RA-ILD cases, the pathogenesis is incompletely understood. In terms of genetic predisposition, external environmental factors act and subsequently determine the activation of immune system cells such as macrophages, neutrophils, B and T lymphocytes, fibroblasts, and dendritic cells. These, in turn, show the ability to secrete molecules with a proinflammatory role (cytokines, chemokines, growth factors) that will produce important visceral injuries, including pulmonary changes. Currently, there is new evidence that supports the initiation of the systemic immune response at the level of pulmonary mucosa where the citrullination process occurs, whereby the autoantibodies subsequently migrate from the lung to the synovial membrane. The aim of this paper is to provide current data regarding the pathogenesis of RA-associated ILD, starting from environmental triggers and reaching the cellular, humoral, and molecular changes involved in the onset of the disease.

Gracilis muscle flap for reconstruction of extensive soft tissue damage to the palm.

The reconstruction of a large palmar soft tissue defect is a challenge to restore both aesthetics and functionality. Reconstruction with fascio-cutaneous and fascial flaps are the most widely used in the literature, few cases are reported using muscular free flap. We report our experience with the use of the free gracilis muscle flap for palmar soft tissue reconstruction in patients with complex hand traumas. We review nine cases of complex soft tissue reconstruction to the palm of the hand using the free gracilis muscle flap performed over a period of 20 years. Eight cases involved acute trauma with damage to underlying structures, necessitating multiple surgical procedures. With an average follow-up of 36 months, the free gracilis muscle flap reconstruction enabled patients to achieve good grip, with skin quality resistant to chronic mechanical stress. All patients recovered a protective sensation to deep pressure. The hand's aesthetic appearance was restored in all cases. Flap harvesting altered neither the function nor silhouette of the donor site. The optimal palmar reconstruction technique depends on patient characteristics, associated trauma, and defect size. In our opinion, the gracilis muscle flap technique is both straightforward and effective in restoring mechanical function of the hand, particularly when a large area of the palm has been impacted.

Major Pelvic Ortho-oncological Surgeries: Our Experience

Background and Aims: Anaesthesia for pelvic tumour surgeries is challenging because of major blood loss, extensive tissue damage, hypothermia due to the longer duration of surgery, unusual and frequent change in positions, ongoing postoperative blood loss and post-operative pain management. This retrospective study aimed to assess the perioperative anaesthetic management for patients undergoing major pelvic tumour surgeries in our institute. Methods: We collected data from 20 patients from the patient files, anaesthesia records and electronic medical records about demographics, type and duration of surgery, pre-operative morbidities, preoperative chemotherapy/radiotherapy, intraoperative anaesthesia management with respect to fluids, blood loss, blood products transfused and postoperative pain management and complications. Data were summarised using percentages for categorical data and medians for continuous data. Results: Sixteen patients were given epidural and general anaesthesia, while four were given only general anaesthesia. The median duration of surgery was 7 h (interquartile range [IQR] 5–10 h). Multiple surgeons were involved in four cases. The median blood loss was 1500 ml (IQR 550–2750 mL); nine patients needed massive blood transfusions. Navigation-guided surgical cuts were made in eight patients. Three required postoperative mechanical ventilation. The pain was managed by epidural infusions and intravenous patient-controlled fentanyl infusions. The postoperative complication was seen in two patients in the form of wound infection and a post-operative bleed. Conclusion: The major pelvic orthopaedic oncological surgeries require meticulous attention to patient-centric perioperative care. A dedicated team approach with a definitive surgical plan, anticipating complications and their timely intervention, pain management and postoperative rehabilitation can lead to improved outcomes.