{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T23:05:46Z","timestamp":1782515146787,"version":"3.54.5"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2003,2,10]],"date-time":"2003-02-10T00:00:00Z","timestamp":1044835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Perineal wounds following abdominoperineal resection (APR), for persistent or locally recurrent anal cancer, are associated with poor healing secondary to irradiation therapy. The results of APR combined with a vertical rectus abdominis musculocutaneous (VRAM) flap transposed transpelvically to cover the perineal defect are presented.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Between 1994 and 2000, 105 patients were diagnosed and treated for anal cancer. Twenty-two (21 per cent) underwent a salvage operation owing to persistent or locally recurrent disease. In eight patients, before 1996, the perineum was closed primarily with serious wound complications in five. In the final 14 patients, primary perineal reconstruction with a VRAM flap was performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median age was 65\u00b75 (range 45\u201378) years. Median follow-up was 14\u00b75 (range 3\u201341) months. There were no flap-related complications and primary healing was achieved in all patients. Median hospital stay was 17 (range 14\u201372) days. There were two major complications related to the laparotomy and abdominal closure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Combining the salvage operation with a VRAM flap facilitates primary healing after surgical treatment for persistent or locally recurrent anal cancer. A single-stage primary reconstructive procedure is feasible, with an acceptable complication rate and high level of patient satisfaction.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.4073","type":"journal-article","created":{"date-parts":[[2003,5,2]],"date-time":"2003-05-02T10:01:45Z","timestamp":1051869705000},"page":"575-580","source":"Crossref","is-referenced-by-count":114,"title":["Use of transpelvic rectus abdominis musculocutaneous flap for anal cancer salvage surgery"],"prefix":"10.1093","volume":"90","author":[{"given":"T M","family":"Tei","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery Z, Aarhus Kommunehospital, Aarhus University Hospitals, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Stolzenburg","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery L, Aarhus Amtssygehus, Aarhus University Hospitals, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Buntzen","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery L, Aarhus Amtssygehus, Aarhus University Hospitals, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Laurberg","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery L, Aarhus Amtssygehus, Aarhus University Hospitals, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Kjeldsen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Z, Aarhus Kommunehospital, Aarhus University Hospitals, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2003,2,10]]},"reference":[{"key":"2021070911282731400_bib1","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1007\/BF02237294","article-title":"Results of salvage abdominoperineal resection for anal cancer after radiotherapy","volume":"41","author":"Pocard","year":"1998","journal-title":"Dis Colon Rectum"},{"key":"2021070911282731400_bib2","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1007\/BF00308639","article-title":"Anal cancer: multimodal therapy","volume":"19","author":"Schlag","year":"1995","journal-title":"World J Surg"},{"key":"2021070911282731400_bib3","first-page":"4073","article-title":"Cancer ani","volume":"158","author":"Kjeldsen","year":"1996","journal-title":"Ugeskr Laeger"},{"key":"2021070911282731400_bib4","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/S0094-1298(20)30625-8","article-title":"Healing in the irradiated wound","volume":"17","author":"Miller","year":"1990","journal-title":"Clin Plast Surg"},{"key":"2021070911282731400_bib5","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/BF00341389","article-title":"Improved perineal wound healing with the omental pedicle graft after rectal excision","volume":"6","author":"John","year":"1991","journal-title":"Int J Colorectal Dis"},{"key":"2021070911282731400_bib6","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1007\/BF02049727","article-title":"Passive vs. closed suction drainage after perineal wound closure following abdominoperineal rectal excision for carcinoma. A multicenter, controlled trial. The French Association for Surgical Research","volume":"38","author":"Fingerhut","year":"1995","journal-title":"Dis Colon Rectum"},{"key":"2021070911282731400_bib7","first-page":"375","article-title":"Disorders of wound healing of the sacral cavity after abdomino-perineal resection of the rectum","volume":"116","author":"Fuchs","year":"1991","journal-title":"Zentralbl Chir"},{"key":"2021070911282731400_bib8","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1007\/BF02555457","article-title":"Abdominal vs. perineal drainage in rectal surgery","volume":"30","author":"Pahlman","year":"1987","journal-title":"Dis Colon Rectum"},{"key":"2021070911282731400_bib9","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/0002-9610(83)90187-3","article-title":"Factors influencing perineal wound healing after proctectomy","volume":"145","author":"Manjoney","year":"1983","journal-title":"Am J Surg"},{"key":"2021070911282731400_bib10","first-page":"1061","article-title":"Methods to decrease the morbidity of abdominoperineal resection","volume":"61","author":"Farid","year":"1995","journal-title":"Am Surg"},{"key":"2021070911282731400_bib11","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1007\/BF02052594","article-title":"Perineal wound management after abdominoperineal rectal excision for carcinoma with unsatisfactory hemostasis or gross septic contamination: primary closure vs. packing. A multicenter, controlled trial. French Association for Surgical Research","volume":"37","author":"Delalande","year":"1994","journal-title":"Dis Colon Rectum"},{"key":"2021070911282731400_bib12","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1007\/BF02586880","article-title":"Management of the perineal wound after rectal excision for neoplastic disease: a controlled clinical trial","volume":"22","author":"Terranova","year":"1979","journal-title":"Dis Colon Rectum"},{"key":"2021070911282731400_bib13","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1097\/00000637-199702000-00004","article-title":"Reconstruction of pelvic exenterative wounds with transpelvic rectus abdominis flaps: a case series","volume":"38","author":"Jain","year":"1997","journal-title":"Ann Plast Surg"},{"key":"2021070911282731400_bib14","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1046\/j.1365-2168.1999.01044.x","article-title":"Primary myocutaneous flap closure following resection of locally advanced pelvic malignancies","volume":"86","author":"Radice","year":"1999","journal-title":"Br J Surg"},{"key":"2021070911282731400_bib15","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s10434-999-0033-4","article-title":"Immediate reconstruction of the perineal wound with gracilis muscle flaps following abdominoperineal resection and intraoperative radiation therapy for recurrent carcinoma of the rectum","volume":"6","author":"Shibata","year":"1999","journal-title":"Ann Surg Oncol"},{"key":"2021070911282731400_bib16","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1006\/gyno.1995.1129","article-title":"Perineal reconstruction using single gracilis myocutaneous flaps","volume":"57","author":"Burke","year":"1995","journal-title":"Gynecol Oncol"},{"key":"2021070911282731400_bib17","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/0007-1226(84)90076-6","article-title":"The versatile deep inferior epigastric (inferior rectus abdominis) flap","volume":"37","author":"Taylor","year":"1984","journal-title":"Br J Plast Surg"},{"key":"2021070911282731400_bib18","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/00006534-198801000-00012","article-title":"Vaginal and pelvic reconstruction with distally based rectus abdominis myocutaneous flaps","volume":"81","author":"Tobin","year":"1988","journal-title":"Plast Reconstr Surg"},{"key":"2021070911282731400_bib19","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/S0094-1298(20)30652-0","article-title":"Refinements in vaginal reconstruction using rectus abdominis flaps","volume":"17","author":"Tobin","year":"1990","journal-title":"Clin Plast Surg"},{"key":"2021070911282731400_bib20","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1006\/gyno.1996.0157","article-title":"Gynecologic reconstruction with a rectus abdominis myocutaneous flap: an update","volume":"61","author":"Carlson","year":"1996","journal-title":"Gynecol Oncol"},{"key":"2021070911282731400_bib21","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1006\/jsre.1999.5664","article-title":"Intradermal injection of autologous dermal fibroblasts improves wound healing in irradiated skin","volume":"85","author":"Ferguson","year":"1999","journal-title":"J Surg Res"},{"key":"2021070911282731400_bib22","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1055\/s-2007-1000187","article-title":"Reconstruction of complex radiation-induced injuries using free-tissue transfer","volume":"14","author":"Gurlek","year":"1998","journal-title":"J Reconstr Microsurg"},{"key":"2021070911282731400_bib23","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1055\/s-2007-1000179","article-title":"Does prior irradiation increase the risk of total or partial free-flap loss?","volume":"14","author":"Kroll","year":"1998","journal-title":"J Reconstr Microsurg"},{"key":"2021070911282731400_bib24","first-page":"28","article-title":"Anatomosis of free flaps to the inferior epigastric artery","volume":"23","author":"Grelich","year":"1991","journal-title":"Handchir Mikrochir Plast Chir"},{"key":"2021070911282731400_bib25","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/00006534-200001000-00029","article-title":"Anterolateral thigh fasciocutaneous flap in the difficult perineogenital reconstruction","volume":"105","author":"Luo","year":"2000","journal-title":"Plast Reconstr Surg"},{"key":"2021070911282731400_bib26","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1097\/00006534-199290020-00016","article-title":"Experience with vaginal reconstruction utilizing the modified Singapore flap","volume":"90","author":"Woods","year":"1992","journal-title":"Plast Reconstr Surg"},{"key":"2021070911282731400_bib27","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1097\/00006534-197608000-00006","article-title":"Vaginal reconstruction with gracilis myocutaneous flaps","volume":"58","author":"McCraw","year":"1976","journal-title":"Plast Reconstr Surg"},{"key":"2021070911282731400_bib28","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1007\/s002380050195","article-title":"The area of transposition of the pedicled deep inferior epigastric perforator flap: an anatomical study","volume":"22","author":"Spauwen","year":"1999","journal-title":"Eur J Plast Surg"},{"key":"2021070911282731400_bib29","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1097\/00000637-199510000-00013","article-title":"The use of the transverse rectus abdominis musculocutaneous flap after abdominoplasty","volume":"35","author":"Sozer","year":"1995","journal-title":"Ann Plast Surg"},{"key":"2021070911282731400_bib30","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1136\/jcp.46.3.228","article-title":"Radiation disease of the urinary tract: histological features of 18 cases","volume":"46","author":"Suresh","year":"1993","journal-title":"J Clin Pathol"},{"key":"2021070911282731400_bib31","first-page":"177","article-title":"Management of the perineal wounds following excision of the rectum for malignancy","volume":"10","author":"Wang","year":"1994","journal-title":"Gaoxiong Yi Xue Ke Xue Za Zhi"},{"key":"2021070911282731400_bib32","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/BF02587192","article-title":"Closure of the pelvic and perineal wounds after removal of the rectum and anus","volume":"23","author":"Page","year":"1980","journal-title":"Dis Colon Rectum"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.4073","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/90\/5\/575\/36727953\/bjs4073.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/bjs\/article-pdf\/90\/5\/575\/36727953\/bjs4073.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T20:59:09Z","timestamp":1625864349000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/90\/5\/575\/6143177"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,2,10]]},"references-count":32,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2003,2,10]]},"published-print":{"date-parts":[[2003,4,30]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.4073","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2003,5]]},"published":{"date-parts":[[2003,2,10]]}}}