Care of the adolescent undergoing an allograft procedure

During the last 25 years, substantial progress has been made in the detection and treatment of bone tumors in adolescents and young adults. Due to more effective chemotherapy treatments, patients are now surviving these illnesses and living quality lives. In the past, the only surgical option for treatment of these tumors was amputation. Today, however, limb-sparing procedures such as allograft implantation, together with effective chemotherapy treatments, provide patients with another treatment option. The allograft procedure includes removing the tumor and affected bone and replacing it with bone procured from deceased donors. During the following 2 years, the body does the work of incorporating the allograft and replacing it, at least in part, with new host bone. After a long rehabilitation process, the patient will have a functioning limb. Nursing care of the adolescent undergoing allograft procedure encompasses meeting important physical and psychosocial needs. Adolescents are often still dealing with the emotional and physical stress of having cancer and chemotherapy or chemotherapy side effects at the time of surgery. They are concerned not only with their immediate recovery but also with their long-term prognosis. All treatment modalities, including allograft surgery, impinges on the normal developmental tasks of adolescents. The nursing challenge is to help the adolescent balance the limits of their illness and recovery with normal developmental needs.