Healing of the perineal wound after proctectomy in Crohn’s disease patients: only preoperative perineal sepsis predicts poor outcome
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...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English English |
| Published: |
Springer Nature
2017
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/69599/ http://irep.iium.edu.my/69599/ http://irep.iium.edu.my/69599/ http://irep.iium.edu.my/69599/1/Elagili%20perineal%20wound.pdf http://irep.iium.edu.my/69599/7/69599_Healing%20of%20the%20perineal%20wound%20after%20proctectomy_scopus.pdf |
| Summary: | 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. |
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