Myocutaneous flap reconstruction of the perineum after radical abdominoperineal resection

Autor: Malcolm S Wilson, Sarah T O'Dwyer, A. N. Ramesh, K. Gajanan, Paul E Fulford
Rok vydání: 2006
Předmět:
Zdroj: Colorectal Disease. 8:816-816
ISSN: 1463-1318
1462-8910
Popis: Objective: Wound dehiscence with nonhealing of the perineum is a significant morbidity associated with radical abdominoperineal resection (APR). Myocutaneous flaps have been used to facilitate primary wound healing. The purpose of this study is to evaluate the results of myocutaneous flap reconstruction of the perineum following radical APR. Method: The clinical records of patients who had myocutaneous flap reconstruction of the perineum between 2000 and 2005 were reviewed. Details of wound healing and complications related to the flaps were recorded. Results: Seventeen patients with a median age of 59 (range 29–77) years had primary reconstruction of the perineum with gracilis (10), rectus abdominis (6) and gluteal (1) myocutaneous flaps. Malignancy of the anus (12) and rectum (4) was the primary pathology and one patient had chronic perianal crohns fistulae. Eleven patients had preoperative radiotherapy in this group. Complete healing of the perineum was achieved in 16 (94.2%) of the 17 patients. There were eight (47%) minor wound dehiscence and two (11%) skin necrosis all of which healed completely and one (5.8%) total flap necrosis. Discussion: Myocutaneous flaps improve wound healing with only minor morbidity in majority of patients and should be considered routinely to close perineal defects following radical APR particularly in irradiated perineum.
Databáze: OpenAIRE
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