Management of the perineal wound following abdominoperineal resection: prospective study of three methods.
A prospective study was made of three procedures for treating the perineal wound and presacral cavity in 102 patients undergoing abdominoperineal excision for cancer of the rectum: (1) packing of the presacral space after suture of the pelvic peritoneum; (2) suture of the pelvic peritoneum and perineal wound, leaving two drains through the perineum; and (3) no suture of the pelvic peritoneum, and primary closure of the perineal wound, leaving drains through the abdomen for physiological saline irrigation. The parameters analysed were incidence of infection, primary healing of the perineum, extraperineal complications and mean hospital stay. Primary healing of the perineum was best with method 3, and overall incidence of infection highest with method 2. There were no differences between the methods with regard to extraperineal complications. Hospital stay was shortest with method 3.
Robles Campos
R
R
Faculty of Medicine, Virgen de la Arrixaca University Hospital, El Palmar, Murcia, Spain.
Garcia Ayllon
J
J
Parrila Paricio
P
P
Cifuentes Tebar
J
J
Lujan Mompean
J A
JA
Liron Ruiz
R
R
Torralba Martinez
J A
JA
Molina Martinez
J
J
D000009:Abdominal Muscles / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery; D013530:Surgical Wound Infection / Q000209:etiology; D013537:Sutures; D014945:Wound Healing