Perineal wound complications, risk factors, and outcome after abdominoperineal resections.

Abstract:

BACKGROUND:We describe the risk factors for complications and outcome of perineal wounds after abdominoperineal resections (APRs). METHODS:A retrospective chart review was performed, and patient demographics, risk factors, extent of APR, closure of perineal wounds, exposure to radiation, and outcome were collected. RESULTS:There were 87 APRs performed during an 8-year period. The mean follow-up period was 2.0 years (range, 18 days to 7.8 y). The mean body mass index (BMI) of the cohort was 27.8 kg/m (range, 16.8-47.5 kg/m). Of these patients, 36 (41%) have normal weight (BMI < 25 kg/m) and 51 (59%) were overweight (BMI > 25 kg/m). Direct closure of the perineum was performed in 67 patients (77%). Twenty patients (23%) had musculocutaneous flap closures of the perineum. Fifty-seven patients (66%) had radiation exposure to the perineal region. Nineteen patients (22%) had complications of the perineal wound. We found that direct closure of the perineum in patients who were overweight (P < 0.05), active smokers (P < 0.05), or had chronic obstructive pulmonary disease (P < 0.01) was associated with higher wound complications. CONCLUSIONS:The use of musculocutaneous flap closures of the perineum after APRs in patients who are overweight (BMI > 25 kg/m), are smokers, or have chronic obstructive pulmonary disease may decrease wound complications.

journal_name

Ann Plast Surg

authors

Choudry U,Harris D

doi

10.1097/SAP.0b013e31823fac2b

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

209-13

issue

2

eissn

0148-7043

issn

1536-3708

journal_volume

71

pub_type

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