Long-term comorbidity of diabetes mellitus is a risk factor for perineal wound complications after an abdominoperineal resection.
BACKGROUND
This report is an attempt to clarify the effect of diabetes mellitus on perineal wound complications including infectious entities and delayed wound healing after abdominoperineal resection and also tried to show the risk factors for perineal wound complications.


METHODS
The data of 80 patients who underwent an abdominoperineal resection were reviewed from April 1996 to March 2006.


RESULTS
The rate of perineal wound complications is higher in diabetics (67%) than in nondiabetics (18%, p = 0.005). In a multivariate analysis, diabetes mellitus and operation time (> or =420 min) were the risk factors for perineal wound complications (p = 0.040, p = 0.027, respectively). Infectious perineal wound complication was associated with diabetes mellitus (p < 0.001) but not with the operation time (p = 0.097). Furthermore, a longer comorbid duration of diabetes (> or =10 years) was a significant predictor for perineal wound complications (p = 0.008).


CONCLUSIONS
This study demonstrated diabetes mellitus to be independently associated with perineal wound complications, and when the patients have diabetes mellitus, especially with a longer comorbid duration and longer operation time, the clinical path should be changed to reduce perineal wound complications.
Matsuda
Kenji
K
Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan.
Hotta
Tsukasa
T
Takifuji
Katsunari
K
Yokoyama
Shozo
S
Higashiguchi
Takashi
T
Tominaga
Toshiji
T
Oku
Yoshimasa
Y
Nasu
Toru
T
Tamura
Koichi
K
Yamaue
Hiroki
H
D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D048909:Diabetes Complications / Q000453:epidemiology* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010502:Perineum / Q000601:surgery; D011379:Prognosis; D012004:Rectal Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000401:mortality; D014945:Wound Healing