Abstract
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.
Keywords
proctectomy - Crohn perineum - perineal wound - surgical site infection
