{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:57:38Z","timestamp":1785509858970,"version":"3.56.0"},"reference-count":9,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:p>Pelvic surgery for malignancy or infection can result in large pelvic floor defects. Standard reconstruction options may not be feasible in patients with prior radiation, significant comorbidities, and\/or malnutrition. We present a low-morbidity salvage approach using an autologous peritoneal graft as a biologic pelvic partition, followed by vacuum-assisted closure, for a large contaminated perineal defect in a patient with a colocutaneous fistula following robotic abdominoperineal resection. An autologous peritoneal graft was harvested from the parietal peritoneum, including tissue from a previous incisional hernia sac, tailored to the required size, and sutured circumferentially to the margins of the defect to partition the pelvic inlet from the peritoneal cavity. A vacuum-assisted closure system was placed on postoperative day (POD) 4 and maintained until POD 43, resulting in marked wound size reduction. This technique offers a tension-free, mesh-free salvage option for selected complex perineal defects, particularly in hostile, irradiated, and contaminated fields where conventional reconstructive strategies may not be feasible.<\/jats:p>","DOI":"10.1177\/00031348261474188","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:42:15Z","timestamp":1785303735000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Hostile Fields and Limited Options: Autologous Peritoneal Grafting as a Salvage Strategy for Complex Perineal Defects"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6725-2228","authenticated-orcid":false,"given":"Charalampos","family":"Theocharopoulos","sequence":"first","affiliation":[{"name":"University of Colorado Anschutz Medical Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9439-6530","authenticated-orcid":false,"given":"Dimitrios N.","family":"Varvoglis","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis A.","family":"Ziogas","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikitas","family":"Vasileiou","sequence":"additional","affiliation":[{"name":"Metaxa Cancer Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elissaios","family":"Kontis","sequence":"additional","affiliation":[{"name":"Metaxa Cancer Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/codi.16224"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000020712"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2004.11.013"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13304-020-00730-9"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/sap.0000000000003868"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2018.00738"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-023-02995-x"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-022-02662-x"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-2058-7983"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261474188","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348261474188","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348261474188","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T13:57:42Z","timestamp":1785506262000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348261474188"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":9,"alternative-id":["10.1177\/00031348261474188"],"URL":"https:\/\/doi.org\/10.1177\/00031348261474188","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"article-number":"00031348261474188"}}