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
Problems:
(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)
where:
• 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.
