Althumairi et al reported predictors of problems with the healing of a perineal wound following an abdominoperineal resection. The authors are from the Johns Hopkins University.

Patient selection: perineal wound following abdominoperineal resection



(1) major complications (infection, necrosis, deep dehiscence)

(2) minor complications (drainage, superficial dehiscence)

(3) delayed wound healing


Rate of major complications: 7%

Rate of minor complicaitons: 22%


Predictors of problems with wound healing:

(1) nutritional status (hypoalbuminemia with serum albumin < 3.5 g/dL; RRR 11.4 for major complications)

(2) current smoking

(3) neoadjuvant chemotherapy

(4) myocutaneous flap reconstruction (9.3 weeks to closure vs 6.3 for primary closure)



• Neoadjuvant radiotherapy and chronic steroid use were included as study variables.


Squamous cell carcinoma (SCC) had a longer time to perineal wound healing in univariate analysis but not the multivariate analysis. Patients with SCC had a high rate of flap reconstructions, which is a risk factor for delayed wound healing.

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