Advantage of vacuum assisted closure on healing of wound associated with omentoplasty after abdominoperineal excision: a
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Case report
Advantage of vacuum assisted closure on healing of wound associated with omentoplasty after abdominoperineal excision: a case report Silvia Cresti, Mehdi Ouaïssi*, Igor Sielezneff, Jean-Baptiste Chaix, Nicolas Pirro, Bruno Berthet, Bernard Consentino and Bernard Sastre Address: Service de Chirurgie Digestive et Oncologique, Pôle d'Oncologie et de Spécialités Médicales et Chirurgicales, Hôpital De la Timone, Marseille, France Email: Silvia Cresti - [email protected]; Mehdi Ouaïssi* - [email protected]; Igor Sielezneff - [email protected]; Jean-Baptiste Chaix - [email protected]; Nicolas Pirro - [email protected]; Bruno Berthet - [email protected]; Bernard Consentino - [email protected]; Bernard Sastre - [email protected] * Corresponding author
Published: 23 December 2008 World Journal of Surgical Oncology 2008, 6:136
doi:10.1186/1477-7819-6-136
Received: 6 July 2008 Accepted: 23 December 2008
This article is available from: http://www.wjso.com/content/6/1/136 © 2008 Cresti et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Primary closure of the perineum with drainage after abdominoperineal excision of the rectum for carcinoma, is widely accepted. However hematoma, perineal abscess and reoperation are significantly more frequent after primary closure than after packing of the perineal cavity. Those complications are frequently related to the patients' clinical antecedent (i.e radiotherapy, diabetes, smoking). Case presentation: In the present report, vacuum assisted drainage was used after abdominoperineal excision for carcinoma in the very first step due to intraoperative gross septic contamination during tumor resection. The first case: A 57-years old man with a 30-years history of peri-anal Crohn's disease, the adenocarcinoma of the lowest part of the rectum and Crohn colitis with multiple area of severe dysplasia required panproctocolectomy with a perineal resection. The VAC system was used during 12 days (changed every 3 days). We observed complete healing 18 days after surgery. The second case: A 51-year-old man, with AIDS. An abdominoperineal resection was performed for recurrence epidermoid anal cancer. The patient was discharged at day 25 and complete healing was achieved 30 days later after surgery. Conclusion: The satisfactory results showed in the present report appear to be favored by association of omentoplasty and VAC system. Those findings led us to favor VAC system in the case of pelvic exenteration associated with high risk of infection.
Background Primary closure of the perineum with drainage after abdominoperineal resection (APR) of the rectum for carcinoma, is widely accepted [1]. Meticulous hemostasis
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