Healing of the perineal wound after proctectomy in Crohn's disease patients: only preoperative perineal sepsis predicts poor outcome.

Abstract:

BACKGROUND:The aim of our study was to assess perineal wound healing in patients with Crohn's disease (CD) who undergo proctectomy or proctocolectomy with end ileostomy and to evaluate the influence of various factors including types of perineal dissection on eventual wound healing. METHODS:Data for patients with CD who underwent proctectomy or total proctocolectomy with end ileostomy from 1995 to 2012 were reviewed. The relationship between perineal wound healing and demographics, patient characteristics, and other factors was assessed using univariate and multivariate analyses. RESULTS:The perineal wound healed by 12 weeks in 72 (52.9%) out of 136 patients (63.2% female, mean age 41 ± 13 years); delayed healing occurred in 35 patients (25.7%), and in 29 patients (21.3%), there was non-healing. On multivariate analysis, the only factor associated with delayed healing and non-healing was preoperative perineal sepsis (p = 0.001). CONCLUSIONS:After proctectomy or proctocolectomy for CD, perineal wound healing is poor and poses a particular challenge for patients with preoperative perineal sepsis. These findings support a preoperative discussion regarding CD patients that examines potential outcomes and the consideration of measures such as the initial creation of defunctioning ostomy or control/drainage of local sepsis prior to proctectomy.

journal_name

Tech Coloproctol

authors

Li W,Stocchi L,Elagili F,Kiran RP,Strong SA

doi

10.1007/s10151-017-1695-8

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

715-720

issue

9

eissn

1123-6337

issn

1128-045X

pii

10.1007/s10151-017-1695-8

journal_volume

21

pub_type

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