Kamrava Allen, Mahmoud Najjia N
LA Colon and Rectal Surgical Associates, Beverly Hills, California.
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Clin Colon Rectal Surg. 2013 Jun;26(2):106-11. doi: 10.1055/s-0033-1348049.
Complex perineal wounds are at risk for nonhealing. High-risk procedures include proctectomy for Crohn disease, anal cancer and radiated distal rectal cancers. A basic understanding of both patient and procedural risk factors is helpful in planning and executing operative procedures for these conditions and to minimize associated wound complications. Diabetes, obesity, and malnutrition may contribute to wound breakdown and failure to heal. Delaying operative intervention, adding nutritional supplementation, and employing intestinal diversion as well as myocutaneous flaps may help optimize conditions for wound healing.
复杂的会阴伤口存在不愈合的风险。高风险手术包括克罗恩病、肛门癌和放射性远端直肠癌的直肠切除术。对患者和手术风险因素有基本的了解，有助于针对这些情况规划和实施手术操作，并将相关伤口并发症降至最低。糖尿病、肥胖和营养不良可能导致伤口破裂和愈合不良。延迟手术干预、补充营养、采用肠道转流以及肌皮瓣移植可能有助于优化伤口愈合条件。
