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Background
Perineal wound problems associated with infection is one of the intractable complications after abdominoperineal resection including pelvic exenteration in rectal cancer. Moreover, the addition of neoadjuvant radiation therapy (with or without chemotherapy) dramatically increases the rate of complications, especially delayed wound healing, wound disruption and severe infection in the case of the resection of the perineum after neoadjuvant chemoradiationtheray. There is much research about the methods for wound healing in patients with cancer after surgery.
Skin grafts, NPWT(negative pressure wound therapy), use of growth factor and the combination of antimicrobial agents is effective for infected wound healing and has been used as an alternative therapy.
Case studies
All patients had been treated with neoadjuvant chemoradiotherapy for rectal carcinoma.
Case 1: A 59-year old woman, the adenocarcinoma of the lowest part of the rectum and a perineal resection. The antimicrobial agent was used during 34 days.
Case 2: A 72-year old woman with diabetes mellitus having an abdominoperineal resection was performed for recurrence rectal cancer and complete wound healing was achieved 30 days later after surgery.
Case 3: A 59-year old with exposed cancer wound associated with bacterial infection around the perineum, having chemoradiotherapy and having a total pelvic exenteration.
Conclusion
Recently, neoadjuvant chemoradiation therapy is accepted as the most effective protocol in advanced rectal cancer.
It is important for patient with rectal cancer having surgery to assess the wound the early stage. A proper method to treat the infected wound in patients with rectal cancer is required.
Perineal wound problems associated with infection is one of the intractable complications after abdominoperineal resection including pelvic exenteration in rectal cancer. Moreover, the addition of neoadjuvant radiation therapy (with or without chemotherapy) dramatically increases the rate of complications, especially delayed wound healing, wound disruption and severe infection in the case of the resection of the perineum after neoadjuvant chemoradiationtheray. There is much research about the methods for wound healing in patients with cancer after surgery.
Skin grafts, NPWT(negative pressure wound therapy), use of growth factor and the combination of antimicrobial agents is effective for infected wound healing and has been used as an alternative therapy.
Case studies
All patients had been treated with neoadjuvant chemoradiotherapy for rectal carcinoma.
Case 1: A 59-year old woman, the adenocarcinoma of the lowest part of the rectum and a perineal resection. The antimicrobial agent was used during 34 days.
Case 2: A 72-year old woman with diabetes mellitus having an abdominoperineal resection was performed for recurrence rectal cancer and complete wound healing was achieved 30 days later after surgery.
Case 3: A 59-year old with exposed cancer wound associated with bacterial infection around the perineum, having chemoradiotherapy and having a total pelvic exenteration.
Conclusion
Recently, neoadjuvant chemoradiation therapy is accepted as the most effective protocol in advanced rectal cancer.
It is important for patient with rectal cancer having surgery to assess the wound the early stage. A proper method to treat the infected wound in patients with rectal cancer is required.