Vacuum-Assisted Closure of Complex Perineal Wounds

Schaffzin, David M.; Douglas, Jennifer M.; Stahl, Thomas J.; Smith, Lee E.

doi:10.1007/s10350-004-0633-9

Cited by 54 publications

(34 citation statements)

References 7 publications

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“…In the early postoperative period, its benefit may relate to drainage of sepsis. Other available treatment includes omentoplasty, 21 gracilis muscle advancement, 22 posterior thigh fasciocutaneous flaps, 23 gluteus maximus V-Y advancement flaps, 23 vacuum assisted closure [24][25][26] and rectus abdominal myocutaneous flaps. 27 Sutured omentoplasty was reported to have a 100% wound healing rate at three months.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting the healing of the perineum following surgery

Jones

Bassett

2013

annals

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North West London Hospitals NHS Trust, UK aBStract INTRODUCTION 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. METHODS 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. RESULTS 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<0.001). In patients who had an unhealed perineum initially, perineal sepsis and surgical treatment were both significantly associated with time to healing (hazard ratio [HR]: 0.54, p=0.03; and HR: 0.42, p=0.01). CONCLUSIONS The presence of pre-existing perineal sepsis is associated with an unhealed perineum following proctectomy in inflammatory bowel disease (IBD) and non-IBD surgery. Further studies are indicated to establish perineal sepsis as a causative factor.

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Section: Discussionmentioning

confidence: 99%

Factors affecting the healing of the perineum following surgery

Jones

Bassett

2013

annals

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“…NPWT protects the wound via a polyurethane foam which is sealed airtight by a polyvinyl foil [12]. A high negative pressure applied allows for continuous drainage of the exudative fluids from the wound bed [13,14]. This enhances wound care management by reducing the need for frequent dressing change, reducing risk of urinary contamination and reducing bacterial counts in the wound [12,14].…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Traumatic Perineal Degloving Injury

Lau¹,

Lim²,

Chen³

et al. 2017

Surgery Curr Res

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Introduction: Degloving injuries are most commonly caused by road traffic accidents and industrial accidents. They result from of a large rotational force, which avulses the skin and subcutaneous tissue from the underlying fascia. The majority of such injuries involve the lower extremities. Perineal degloving injury is seldom reported in the literature. Presentation of case:In this case report, we present the case of a 22 year old male pedestrian involved in a motor vehicle accident. He sustained an open perineal degloving injury.

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“…3). The subatmospheric pressure drains the excessive fluid from the extravascular space, thereby improving the local blood flow and oxygenation [52]. The size of the remaining cavity is limited by using the close rectal dissection technique and leaving the mesorectal tissue behind, and preexisting sepsis can be treated effectively by applying the endosponge.…”

Section: Transperineal Completion Proctectomymentioning

confidence: 99%

Surgery for Crohns Disease: New Developments

Gardenbroek

Tanis²,

Buskens³

et al. 2012

Dig Surg

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Background/Aims: Crohn’s disease is a chronic relapsing inflammatory bowel disease requiring surgery in a large number of patients. This review describes new developments in surgical techniques for treating Crohn’s disease. Results: Single-incision laparoscopic surgery decreases abdominal wall trauma by reducing the number of abdominal incisions, possibly improving postoperative results in terms of pain and cosmetics. The resected specimen can be extracted through the single-incision site or the future stoma site. Another option is to use natural orifices for extraction (i.e. transcolonic/transanal), but actual benefits of these procedures have not yet been determined. In patients with extensive perianal disease or rectal involvement, transperineal completion proctectomy is often feasible, thereby avoiding relaparotomy. By using a close rectal intersphincteric resection, damage to the pelvic autonomic nerves is avoided. In addition, the risk of presacral abscess formation is reduced by leaving the mesorectal tissue behind. Conclusion: Minimally invasive surgery and associated techniques have become standard clinical practice in surgical treatment of patients with Crohn’s disease. New developments aim at further reducing the hospital stay and morbidity, and improving the cosmetic outcomes.

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Vacuum-Assisted Closure of Complex Perineal Wounds

Cited by 54 publications

References 7 publications

Factors affecting the healing of the perineum following surgery

Factors affecting the healing of the perineum following surgery

A Case Report of Traumatic Perineal Degloving Injury

Surgery for Crohns Disease: New Developments

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Vacuum-Assisted Closure of Complex Perineal Wounds

Cited by 54 publications

References 7 publications

Factors affecting the healing of the perineum following surgery

Factors affecting the healing of the perineum following surgery

A Case Report of Traumatic Perineal Degloving Injury

Surgery for Crohns Disease: New Developments

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Product

Resources

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Surgery for Crohns Disease: New Developments