The morbidity of perineal wounds following abdominoperineal resection for rectal carcinoma

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Abstract
The clinical charts of 44 patients who underwent an abdominoperineal resection for adenocarcinoma of the rectum at Roswell Park Memorial Institute were retrospectively reviewed. The morbidity of an open perineal wound versus the closed perineal wound were evaluated. All of the patients received a Nichol's bowel preparation and following the abdominal portion of the dissection reperitonealization of the pelvic floor was performed. The overall morbidity for the open perineal wounds was 21% compared to a morbidity of 63% for the perineal wounds that were closed primarily. The mean length of hospitalization from the time of abdomino-perineal resection was 21 days for the open perineal group and 22 days for the closed perineal group. The inclusion of wound sinus tracts in our morbidity assessment may explain the higher complication rate of the closed wound group than previously reported in the literature. This retrospective review emphasizes that the morbidity of the open perineal wound following abdominoperineal resection has been overemphasized. One is trading a potentially increased incidence of septic wound complications in the closed perineum for a protracted wound closure in the open perineum.