Primary closure versus vertical rectus abdominis myocutaneous (VRAM) flap closure of perineal wound following abdominoperineal resection—a systematic review and meta-analysis.

Autor: Temperley, Hugo C., Shokuhi, Poorya, O'Sullivan, Niall J., Mac Curtain, Benjamin, Waters, Caitlin, Murray, Alannah, Buckley, Christina E., O'Neill, Maeve, Mehigan, Brian, McCormick, Paul H., Kelly, Michael E., Larkin, John O.
Zdroj: Irish Journal of Medical Science; Aug2024, Vol. 193 Issue 4, p1721-1728, 8p
Abstrakt: Purpose/aim: Perianal wound healing and/or complications are common following abdominoperineal resection (APR). Although primary closure is commonly undertaken, myocutaneous flap closure such as vertical rectus abdominis myocutaneous flap (VRAM) is thought to improve wound healing process and outcome. A comprehensive meta-analysis was performed to compare outcomes of primary closure versus VRAM flap closure of perineal wound following APR. Methods: PubMed, MEDLINE, EMBASE, and Cochrane Central Registry of Controlled Trials were comprehensively searched until the 8th of August 2023. Included studies underwent meta-analysis to compare outcomes of primary closure versus VRAM flap closure of perineal wound following APR. The primary outcome of interest was perineal wound complications, and the secondary outcomes were abdominal wound complications, dehiscence, wound healing time, length of hospital stay, and mortality. Results: Ten studies with 1141 patients were included. Overall, 853 patients underwent primary closure (74.8%) and 288 patients underwent VRAM (25.2%). Eight studies reported on perineal wound complications after APR: 38.2% (n = 263/688) in the primary closure group versus 32.8% (n = 80/244) in the VRAM group. Perineal complication rates were statistically significantly lower in the VRAM group versus primary closure ((M-H OR, 1.61; 95% CI 1.04–2.49;

Databáze: Complementary Index
Externí odkaz: