AI Article Synopsis
- * Out of the patients analyzed, 44.4% experienced minor wound complications, with some needing reoperations, yet most complications were successfully managed without major interventions.
- * The findings suggest that GFR is a viable option for reconstructing high-risk perineal wounds, providing effective outcomes with manageable levels of morbidity.
Article Abstract
Background: Gracilis flap reconstruction (GFR) following abdominoperineal resection (APR) or proctocolectomy (PC) can reduce pelvic wound complications but has not been adequately assessed in the setting of immunosuppression, fistulous disease, and neoadjuvant chemoradiation.
Methods: Patients undergoing APR/PC with GFR were retrospectively analyzed with regard to perioperative characteristics, and morbidity was assessed.
Results: Patients underwent GFR for rectal cancer ( = 28), anal cancer ( = 3), inflammatory bowel disease ( = 13), or benign fistulizing disease ( = 1). 22.2% were chronically immunosuppressed, and 66.7% underwent preoperative chemoradiation. Twenty (44.4%) patients had minor wound complications, all treated nonoperatively. Nine patients had major complications with 4 patients requiring reoperation. The 4 threatened flaps were unilateral, and all were salvaged. Donor site morbidity was minimal. Patients with major complications were older (56 vs. 71 years, = .030), and less likely to have pelvic drains ( = .018).
Conclusion: In high-risk perineal wounds, GFR offers durable reconstruction with acceptably low morbidity.
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| http://dx.doi.org/10.1177/00031348211011146 | DOI Listing |
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