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Healing of the perineal wound after proctectomy in Crohn’s disease patients: only preoperative perineal sepsis predicts poor outcome

Li, W. and Stocchi, Luca L. and Elagili, Faisal and Strong, Scott A. (2017) Healing of the perineal wound after proctectomy in Crohn’s disease patients: only preoperative perineal sepsis predicts poor outcome. Techniques in Coloproctology, 21 (9). pp. 715-720. ISSN 1123-6337 E-ISSN 1128-045X

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Abstract

Background The aim of our study was to assess perineal wound healing in patients with Crohn’s disease (CD) who undergo proctectomy or proctocolectomy with end ileostomy and to evaluate the infuence of various factors including types of perineal dissection on eventual wound healing. Methods Data for patients with CD who underwent proctectomy or total proctocolectomy with end ileostomy from 1995 to 2012 were reviewed. The relationship between perineal wound healing and demographics, patient characteristics, and other factors was assessed using univariate and multivariate analyses. Results The perineal wound healed by 12 weeks in 72 (52.9%) out of 136 patients (63.2% female, mean age 41 ± 13 years); delayed healing occurred in 35 patients (25.7%), and in 29 patients (21.3%), there was non-healing. On multivariate analysis, the only factor associated with delayed healing and non-healing was preoperative perineal sepsis (p = 0.001). Conclusions After proctectomy or proctocolectomy for CD, perineal wound healing is poor and poses a particular challenge for patients with preoperative perineal sepsis. These fndings support a preoperative discussion regarding CD patients that examines potential outcomes and the consideration of measures such as the initial creation of defunctioning ostomy or control/drainage of local sepsis prior to proctectomy.

Item Type: Article (Journal)
Additional Information: 8115/6959
Uncontrolled Keywords: Crohn’s disease; Proctectomy; Proctocolectomy; Perineal wound healing
Subjects: R Medicine > RD Surgery
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): Kulliyyah of Medicine
Kulliyyah of Medicine > Department of Surgery
Depositing User: Asst Prof Faisal Elagili
Date Deposited: 22 Mar 2019 15:59
Last Modified: 22 Mar 2019 16:35
URI: http://irep.iium.edu.my/id/eprint/69599

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