{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T05:47:27Z","timestamp":1791697647317,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,5,17]],"date-time":"2019-05-17T00:00:00Z","timestamp":1558051200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>A variety of tissue flaps have been described for the closure of perineal wounds following abdominoperineal excision of the rectum (<jats:styled-content style=\"fixed-case\">APE<\/jats:styled-content>) or exenteration for locally advanced\/recurrent rectal cancer and salvage surgery for anal cancer. The aim of this study was to demonstrate the utility of the bilateral pedicled gracilis muscle flaps (<jats:styled-content style=\"fixed-case\">BPGMF<\/jats:styled-content>s) as a reconstruction option in these patients. This is of particular benefit when using a laparoscopic approach for the abdominal component of the operation, avoiding disruption of the abdominal wall and risk of herniation with other reconstruction options, e.g. vertical rectus abdominis myocutaneous flaps.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This is a retrospective single centre case series of patients who underwent reconstruction of perineal defects using <jats:styled-content style=\"fixed-case\">BPGMF<\/jats:styled-content>s using a novel weave technique, from January 2008 to August 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 25 patients (16 female), with a median follow\u2010up of 19 months (3\u2013102). The indications for <jats:styled-content style=\"fixed-case\">BPGMF<\/jats:styled-content>s were cancer resection (21) and perineal hernia (4). The median length of stay was 14 days (6\u201360). All\u2010cause mortality was 36% within the follow\u2010up period. A healed perineal wound was achieved in 72% of patients within 30 days (84% of patients received neoadjuvant chemoradiotherapy). The overall donor site complication rate was 20% (including infection, dehiscence, numbness, haematoma and seroma) and 28% for the perineal site (including infection, dehiscence and prolapse).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BPGMFs provide an important option for reconstruction of the perineum particularly with a minimally invasive approach or with two stomas.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14654","type":"journal-article","created":{"date-parts":[[2019,4,24]],"date-time":"2019-04-24T15:52:34Z","timestamp":1556121154000},"page":"910-916","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Single centre experience of bilateral gracilis flap perineal reconstruction following extra\u2010levator abdominoperineal excision"],"prefix":"10.1111","volume":"21","author":[{"given":"J. A. J.","family":"Coelho","sequence":"first","affiliation":[{"name":"Department of Plastic &amp; Reconstructive Surgery Royal Devon &amp; Exeter Hospital Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4891-1191","authenticated-orcid":false,"given":"F. D.","family":"McDermott","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Devon &amp; Exeter Hospital Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Cameron","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Devon &amp; Exeter Hospital Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3043-8324","authenticated-orcid":false,"given":"N. J.","family":"Smart","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Devon &amp; Exeter Hospital Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. M.","family":"Watts","sequence":"additional","affiliation":[{"name":"Department of Plastic &amp; Reconstructive Surgery Royal Devon &amp; Exeter Hospital Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9114-0812","authenticated-orcid":false,"given":"I. R.","family":"Daniels","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Royal Devon &amp; Exeter Hospital Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14258"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13423"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000837"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000103"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.14348"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12610"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2011.10.001"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2016.10.025"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198167020-00007"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.13933"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-195206000-00010"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02068073"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02562646"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(85)80091-X"},{"key":"e_1_2_7_16_1","first-page":"212","article-title":"Closure of postproctectomy perineal sinus with gracilis muscle flaps","volume":"30","author":"Pezim ME","year":"1987","journal-title":"Can J Surg"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-198312000-00011"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800630514"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1348049"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002107"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001137"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181d0ab23"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199506000-00015"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182268a99"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.14654","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.14654","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.14654","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T15:36:59Z","timestamp":1694273819000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.14654"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,17]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1111\/codi.14654"],"URL":"https:\/\/doi.org\/10.1111\/codi.14654","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,17]]},"assertion":[{"value":"2018-11-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}