Towards the reduction of surgical site infection rates in colorectal surgery

Reeves, Nicola; Williams, G. L.

doi:10.1111/codi.15970

Cited by 1 publication

(1 citation statement)

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“…Within this study, SSI was defined as either documented evidence in the medical records and/or a positive wound culture within 30 days of surgery. A recent United Kingdom national snapshot audit documented SSI rates following surgery on the rectum being 22.6% [11]. The presented SSI rates in this study are therefore comparable.…”

Section: Discussionsupporting

confidence: 74%

Outcomes Following Immediate Vertical Rectus Abdominis Myocutaneous (VRAM) Flap‐Based Perineal Reconstruction Following Resectional Surgery For Pelvic Malignancies

et al. 2021

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Background Increasingly radical surgery combined with neo-adjuvant radiotherapy present a challenge for the reconstructive surgeon. The study objective was to review outcomes of Vertical Rectus Abdominis Myocutaneous (VRAM) flap-based perineal reconstruction following resectional surgery for pelvic malignancies. Methods Single-centre retrospective analysis of patients undergoing immediate VRAM flap reconstruction of a perineal/pelvic defect for pelvic malignancy between July 2009 and November 2017. Primary outcome was perineal morbidity (surgical site infection (SSI), flap loss or dehiscence and perineal hernia). Secondary outcomes were length of stay and donor site morbidity (SSI, full-thickness dehiscence and incisional hernia). Results A total of 178 patients (96 females) were included. Median age was 67 years (range 28-88). The majority were performed for locally advanced rectal adenocarcinoma (n = 122; 68.5%) and 136 (76.4%) patients had received neoadjuvant radiotherapy. Four patients had complete flap loss (2.3%), and 40 had perineal dehiscence (22.5%); however, only, 18 patients required a return to theatre during the admission for perineal-related complications (10.1%). Abdominal dehiscence occurred in six patients (3.4%). Median length of post-operative stay was 15 days (6-131). Sixty-day mortality rate was 1.1%. SSI at the midline and perineum occurred in 34 (19.1%) and 38 patients (21.3%), respectively. At 90-day post-operatively, 75.6% of perineal wounds were healed. During a median followup of 44.5 months, twelve, eleven and 39 patients were diagnosed with perineal, midline and parastomal hernias, respectively (6.9%, 6.2% and 21.9%). Conclusions It is important to have accurate knowledge of perineal and donor-site morbidity rates to allow an informed consent process.

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Section: Discussionsupporting

confidence: 74%