{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T04:45:36Z","timestamp":1791780336596,"version":"4.3.4"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This retrospective cohort study aimed to determine the incidence of persistent perineal sinus (PPS) after proctectomy for Crohn disease (CD) and to identify associated risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary Background Data:<\/jats:title>\n                    <jats:p>Proctectomy remains necessary in a subset of patients with CD, yet impaired perineal wound healing and PPS continue to represent major sources of postoperative morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All patients undergoing proctectomy for CD between 1993 and 2023 at a tertiary referral center were included. The primary outcome was development of PPS, defined as a perineal wound remaining unhealed for \u22656 months after proctectomy. Associated risk factors were analyzed using regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 139 patients, 66.20% were women, and PPS occurred in 26. Healing was 81.30% (95% CI, 74.40%\u201387.30%) at 6 months and 93.50% (95% CI, 88.60%\u201396.80%) at 12 months; median healing time was 1.80 months (IQR, 0.90\u20134.60).<\/jats:p>\n                    <jats:p>Patients operated after 2011 (n=113, 81.30%) were significantly older, more ASA III, and active smokers, with longer disease duration, lower CRP, and higher number of advanced therapies.<\/jats:p>\n                    <jats:p>\n                      PPS was associated with younger age (OR 0.79;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.014) and omentoplasty (OR 2.60;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.036). After correction for year of surgery, only older age independently predicted faster healing (OR 0.90; 95% CI, 0.83\u20130.97;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.005), while \u22653 therapy lines showed a nonsignificant protective effect (OR 0.36; 95% CI, 0.12\u20131.07;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.067).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although PPS remains frequent after proctectomy for Crohn disease, most patients ultimately achieve perineal healing. Older age at surgery is the only independent predictor of faster healing. Improved control of systemic inflammation may reduce the risk of PPS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/sla.0000000000007168","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:28:04Z","timestamp":1786724884000},"page":"1057-1062","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and Risk Factors for Persistent Perineal Sinus After Proctectomy in Crohn Disease"],"prefix":"10.1097","volume":"284","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0266-727X","authenticated-orcid":false,"given":"Wout","family":"De Coster","sequence":"first","affiliation":[{"name":"Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 J.L.","family":"D\u2019Hoore","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Vandeuren","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leen","family":"Van Langenhoven","sequence":"additional","affiliation":[{"name":"Interuniversity Centre for Biostatistics and Statistical Bioinformatics, Catholic University of Leuven and University of Hasselt, Leuven and Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Fieuws","sequence":"additional","affiliation":[{"name":"Interuniversity Centre for Biostatistics and Statistical Bioinformatics, Catholic University of Leuven and University of Hasselt, Leuven and Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Wolthuis","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Bislenghi","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"R1-20261012","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1002\/bjs.4613","article-title":"Perianal Crohn\u2019s disease","volume":"91","author":"Singh","year":"2004","journal-title":"Br J Surg"},{"key":"R2-20261012","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1055\/s-2007-991032","article-title":"Management of nonhealing perineal wounds","volume":"20","author":"Genua","year":"2007","journal-title":"Clin Colon Rectal Surg"},{"key":"R3-20261012","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1111\/codi.12796","article-title":"Factors affecting the fate of faecal diversion in patients with perianal crohn\u2019s disease","volume":"17","author":"Gu","year":"2015","journal-title":"Colorectal Dis"},{"key":"R4-20261012","doi-asserted-by":"crossref","first-page":"2802","DOI":"10.3390\/jcm14082802","article-title":"Long-term complications of proctectomy for refractory perianal Crohn\u2019s disease: a narrative review","volume":"14","author":"Alves Martins","year":"2025","journal-title":"J Clin Med"},{"key":"R5-20261012","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/BF02236990","article-title":"Audit of singsle-stage proctocolectomy for Crohn\u2019s disease postoperative complications and recurrence","volume":"43","author":"Yamamoto","year":"2000","journal-title":"Diseases of the Colon & 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Res"},{"key":"R12-20261012","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1093\/ibd\/izae198","article-title":"TOpClass Class 4 Perineal Crohn\u2019s disease: a systematic review and meta-analysis of perineal wound complication after proctectomy in Crohn\u2019s patients","volume":"31","author":"Alipouriani","year":"2025","journal-title":"Inflamm Bowel Dis"},{"key":"R13-20261012","doi-asserted-by":"crossref","first-page":"e70227","DOI":"10.1111\/codi.70227","article-title":"Long-term perineal wound healing and re-operation rates after proctectomy in patients with inflammatory bowel disease\u2014a retrospective multicentre study","volume":"27","author":"Berghog","year":"2025","journal-title":"Colorectal Dis"},{"key":"R14-20261012","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1093\/ecco-jcc\/jjy131","article-title":"Persistent mesorectal inflammatory activity is associated with complications after proctectomy in Crohn\u2019s disease","volume":"13","author":"De 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Omentoplasty for persistent perineal sinus after proctectomy for Crohn\u2019s disease","volume":"181","author":"Yamamoto","year":"2001","journal-title":"Am J Surg"},{"key":"R22-20261012","doi-asserted-by":"crossref","first-page":"102048","DOI":"10.1016\/j.gassur.2025.102048","article-title":"Perineal wound complications after proctectomy for Crohn\u2019s disease: the impact of the omental pedicle flap and predictors of return to the operating room","volume":"29","author":"Reynolds","year":"2025","journal-title":"J Gastrointest Surg"},{"key":"R23-20261012","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1111\/codi.15276","article-title":"Optimizing omentoplasty for management of chronic pelvic sepsis by intra-operative fluorescence angiography: a comparative cohort study","volume":"22","author":"Slooter","year":"2020","journal-title":"Colorectal Dis"}],"container-title":["Annals of 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