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...

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Main Authors: Li, W., Stocchi, Luca L., Elagili, Faisal, Strong, Scott A.
Format: Article
Language:English
English
Published: Springer Nature 2017
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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
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spelling iium-695992019-03-22T08:35:09Z http://irep.iium.edu.my/69599/ Healing of the perineal wound after proctectomy in Crohn’s disease patients: only preoperative perineal sepsis predicts poor outcome Li, W. Stocchi, Luca L. Elagili, Faisal Strong, Scott A. RD Surgery 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. Springer Nature 2017-09-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/69599/1/Elagili%20perineal%20wound.pdf application/pdf en http://irep.iium.edu.my/69599/7/69599_Healing%20of%20the%20perineal%20wound%20after%20proctectomy_scopus.pdf 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 https://link.springer.com/article/10.1007%2Fs10151-017-1695-8 10.1007/s10151-017-1695-8
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
English
topic RD Surgery
spellingShingle RD Surgery
Li, W.
Stocchi, Luca L.
Elagili, Faisal
Strong, Scott A.
Healing of the perineal wound after proctectomy in Crohn’s disease patients: only preoperative perineal sepsis predicts poor outcome
description 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.
format Article
author Li, W.
Stocchi, Luca L.
Elagili, Faisal
Strong, Scott A.
author_facet Li, W.
Stocchi, Luca L.
Elagili, Faisal
Strong, Scott A.
author_sort Li, W.
title Healing of the perineal wound after proctectomy in Crohn’s disease patients: only preoperative perineal sepsis predicts poor outcome
title_short Healing of the perineal wound after proctectomy in Crohn’s disease patients: only preoperative perineal sepsis predicts poor outcome
title_full Healing of the perineal wound after proctectomy in Crohn’s disease patients: only preoperative perineal sepsis predicts poor outcome
title_fullStr Healing of the perineal wound after proctectomy in Crohn’s disease patients: only preoperative perineal sepsis predicts poor outcome
title_full_unstemmed Healing of the perineal wound after proctectomy in Crohn’s disease patients: only preoperative perineal sepsis predicts poor outcome
title_sort healing of the perineal wound after proctectomy in crohn’s disease patients: only preoperative perineal sepsis predicts poor outcome
publisher Springer Nature
publishDate 2017
url 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
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last_indexed 2023-09-18T21:38:48Z
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