Factors affecting the healing of the perineum following surgery

The aim of this study was to establish patient and procedural factors associated with the development of an unhealed perineum in patients undergoing a proctectomy or excision of an ileoanal pouch. A review of 194 case notes for procedures performed between 1997 and 2009 was carried out. All patients...

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Bibliographic Details
Published in:Annals of the Royal College of Surgeons of England 2013-05, Vol.95 (4), p.252-257
Main Authors: Ip, B, Jones, M, Bassett, P, Phillips, R
Format: Article
Language:English
Subjects:
Body mass index
Cancer
Colon
Colonic Diseases - physiopathology
Colonic Diseases - surgery
Colonic Pouches - physiology
Colorectal
Diabetes
Female
Humans
Inflammatory bowel disease
Inflammatory Bowel Diseases - physiopathology
Inflammatory Bowel Diseases - surgery
Male
Middle Aged
Patients
Perineum - physiology
Perineum - surgery
Postoperative Complications - physiopathology
Radiation therapy
Rectum - surgery
Retrospective Studies
Sepsis
Sepsis - physiopathology
Sinuses
Surgery
Variables
Wound healing
Wound Healing - physiology
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Summary:The aim of this study was to establish patient and procedural factors associated with the development of an unhealed perineum in patients undergoing a proctectomy or excision of an ileoanal pouch. A review of 194 case notes for procedures performed between 1997 and 2009 was carried out. All patients had at least 12 months' follow-up. Univariate and multivariate analyses were performed in 16 parameters. For those patients who developed an unhealed perineum, Cox regression analysis was performed to establish healing over a 12-month period. Two hundred patients were included in the study, of which six had unknown wound status and were subsequently excluded. This left 194 study patients. Of these, 86 (44%) achieved primary wound healing with a fully healed perineum and 108 (56%) experienced primary wound failure. With reference to the latter, 63 (58%) healed by 12 months. Comparing patients with an initially intact perineum with those with initial wound failure showed pre-existing sepsis was highly relevant (odds ratio: 4.32, 95% confidence interval [CI]: 2.16-8.62, p
ISSN:0035-8843
1478-7083
DOI:10.1308/003588413X13511609958451