6255 Perineal Wound Complications Following Abdominoperineal Resection: An Exploration of Risk Factors, Preventive and Management Options

Karen J. Riemenschneider, RN-BC, MS, CWOCN1, Donna Truland, BS, RN, CWOCN2 and Jody Scardillo, MS, RN, ANP-BC, CWOCN1, (1)Albany Medical Center, Clinical Nurse Specialist, Albany, NY, (2)Albany Medical Center, Nurse Clinician, Albany, NY
Purpose: To explore the risk factors and associated complications that affect perineal wound healing after abdominoperineal resection for anal cancer, rectal cancer, and Inflammatory Bowel Disease (IBD).

Objective: Nonhealing perineal wounds are an unpleasant complication following abdominoperineal resection and a common occurrence. Several risk factors are strong predictors of these complications, such as operative technique, preoperative radiation therapy, infection, systemic corticosteroid therapy, and underlying diseases. Some patient risk factors include age, gender, obesity, smoking, anemia, malnutrition.  These complications can result in significant morbidity that may require prolonged hospital stay, hospital readmission, home care nursing wound care needs, and the expenditure of significant medical and nursing costs. The aim of this abstract and proposed study is to explore and evaluate the risk factors associated with impaired wound healing after abdominoperineal resection and investigate preventive and management options.

Proposed Outcomes: A thorough evaluation to identify and define the problem is necessary in order to implement effective management for these patients. In doing so, we hope to be able to identify patients pre-operatively based upon associated risk factors and be able to implement standardized processes and management strategies to prevent and / or decrease the risk of perineal wound development after abdominoperineal resection.

Conclusion: With the implementation of this study and investigation, we hope to gain some insight into what the common risk factors are that impact wound healing in the abdominoperineal resection patient and be able to put in place standardized clinical practice guidelines that will decrease and /or prevent perineal wound development postoperatively. Through these standardized practices, it is our expectation to promote quality patient outcomes and decrease costs in this patient population.