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Vol. 125 No. 10, October 1990 |
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PAPERS READ BEFORE THE 61ST ANNUAL MEETING OF THE PACIFIC COAST SURGICAL ASSOCIATION, LAGUNA NIGUEL, CALIF, FEBRUARY 18 TO FEBRUARY 21, 1990 |
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The Recalcitrant Perineal Wound After Rectal ExtirpationApplications of Muscle Flap Closure
James P. Anthony, MD;
Stephen J. Mathes, MD
Arch Surg. 1990;125(10):1371-1377.
Abstract
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• Perineal wounds developing after abdominoperineal resection result in chronic purulent drainage and intermittent episodes of sepsis and are generally unresponsive to conservative medical and surgical treatment. Thirteen consecutive patients (aged 27 to 74 years; mean, 48 years) who underwent débridement and immediate muscle flap closure of these wounds were analyzed to identify risk factors for delayed healing and to evaluate the effectiveness of muscle flap coverage. Three risk factors were identified: preoperative or postoperative radiation therapy, resection for recurrent carcinoma, and inflammatory bowel disease. A total of 19 muscle flaps (11 gracilis, five gluteal thigh, two gluteus maximus, and one rectus abdominis) were used to close these wounds. During an average 3.5-year follow-up, four (31%) minor complications and one (8%) recurrence were noted to occur. Muscle flaps provide safe, effective, single-stage procedures for the closure of chronic perineal wounds.
(Arch Surg. 1990;125:1371-1377)
Author Affiliations
From the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California, San Francisco.
Footnotes
Accepted for publication June 29, 1990.
Read before the 61st Annual Meeting of the Pacific Coast Surgical Association, Laguna Niguel, Calif, February 20, 1990.
Reprint requests to the Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California, San Francisco, 350 Parnassuss, Suite 509, San Francisco, CA 94143-0932 (Dr Mathes).
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