{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:46:12Z","timestamp":1791384372135,"version":"4.3.3"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2006,12,12]],"date-time":"2006-12-12T00:00:00Z","timestamp":1165881600000},"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":[[2007,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Objective\u2002<\/jats:bold> Nonhealing perineal wound is an unpleasant complication of surgical excision of the rectum and anus. The aim of the study was to evaluate the risk factors for impaired perineal wound healing after abdominoperineal resection (APR) of rectum for adenocarcinoma, particularly with the increasing use of neo\u2010adjuvant chemoradiation.<\/jats:p><jats:p><jats:bold>Method\u2002<\/jats:bold> The study included 38 consecutive patients (29 men, nine women; median age 66\u2003years, range: 43\u201386), who underwent surgical excision of rectum and anus for adenocarcinoma from 1999 to 2004. Thirty\u2010seven patients underwent APR of rectum and one patient, who developed carcinoma in the background of chronic ulcerative colitis, had panproctocolectomy. Associations between the failure of the perineal wound to heal and a number of patient, tumour and treatment\u2010related variables were evaluated by Pearson chi\u2010square test or Fisher's exact test, as appropriate. A <jats:italic>P<\/jats:italic>\u2010value of &lt;0.05 was considered significant. Multivariate statistical technique of principal component analysis was also used to identify risk factors and their relative contribution to impaired healing.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Impaired healing of the perineal wound was observed in 10 (26%) of 38 patients. In four of them (11%) the wound remained nonhealed in 1\u2003year after surgery. Preoperative radiotherapy, delayed primary closure of the wound and alcohol consumption in excess of 28\u2003units\/week was statistically significantly associated with impaired wound healing. Principal component analysis identified the following seven factors that cumulatively contributed to 96% of impaired healing: (i) distant metastases, (ii) preoperative radiotherapy, (iii) T\u2010stage of the tumour, (iv) smoking, (v) perioperative blood transfusion, (vi) preoperative chemotherapy and (vii) development of side effects of preoperative chemoradiation.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> Patients who undergo APR of rectum are prone to impaired healing of the perineal wound if radiotherapy is used to treat malignancy prior to surgery and wound closure is delayed. In addition, the wound may not heal in patients with distant metastases, excessive alcohol consumption, present and past smokers and those who suffer adverse effects of preoperative chemoradiation and require blood transfusion.<\/jats:p>","DOI":"10.1111\/j.1463-1318.2006.01159.x","type":"journal-article","created":{"date-parts":[[2006,12,13]],"date-time":"2006-12-13T15:56:25Z","timestamp":1166025385000},"page":"362-367","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":116,"title":["Risk factors for impaired healing of the perineal wound after abdominoperineal resection of rectum for carcinoma"],"prefix":"10.1111","volume":"9","author":[{"given":"D. Y.","family":"Artioukh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. A.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Gokul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,12,12]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.10.041"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800801040"},{"key":"e_1_2_7_4_2","first-page":"1061","article-title":"Methods to decrease the morbidity of abdominoperineal resection","volume":"61","author":"Farid H","year":"1995","journal-title":"Am Surg"},{"key":"e_1_2_7_5_2","first-page":"388","article-title":"Morbidity and mortality following abdominoperienal resection for low rectal adenocarcinoma","volume":"53","author":"Luna\u2010P\u00e9rez P","year":"2001","journal-title":"Rev Invest Clin"},{"key":"e_1_2_7_6_2","volume-title":"Principal Component Analysis","author":"Jolliffe IT","year":"2002"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199002000-00011"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19900701)66:1<49::AID-CNCR2820660111>3.0.CO;2-1"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.8.1008"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06409-1"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02305759"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199704033361402"},{"key":"e_1_2_7_13_2","first-page":"126","volume-title":"Challenges in Colorectal Cancer","author":"P\u00e5hlman L","year":"2000"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.20.3.817"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)05348-2"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2005.00796.x"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0855-x"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)99076-7"},{"key":"e_1_2_7_19_2","first-page":"454","article-title":"The bottom end. 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