Management of sacral and perineal defects following abdominoperineal resection and radiation with transpelvic muscle flaps

Scott J. Loessin, N. Bradly Meland, Richard M. Devine, Bruce G. Wolff, Heidi Nelson, Horst Zincke

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

PURPOSES: In this study we present our experience with treating persistent sacral and perineal defects secondary to radiation and abdominoperineal resection with or without sacrectomy. METHODS: Fifteen consecutive patients were treated with an inferiorly based transpelvic rectus abdominis muscle or musculocutaneous flap. RESULTS: Fourteen of the 15 patients achieved healing, and 7 patients had no complications. The remaining eight patients required one or more operative debridements and/or prolonged wound care to accomplish a healed wound. Our technique for the dissection and insetting of the transpelvic muscle flap is presented. CONCLUSION: The difficult postirradiated perineal and sacral wounds can be healed with persistent surgical attention to adequate debridement, control of infections, and a well-vascularized muscle flap. The most satisfying aspects for patients are the discontinuance of foul-smelling discharge, discontinuation of multiple, daily dressing changes, and reduction in the degree of chronic pain.

Original languageEnglish (US)
Pages (from-to)940-945
Number of pages6
JournalDiseases of the Colon & Rectum
Volume38
Issue number9
DOIs
StatePublished - Sep 1 1995

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Keywords

  • Rectus abdominis myocutaneous flap
  • Sacral and perineal defects

ASJC Scopus subject areas

  • Gastroenterology

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