Risk factors for wound complications after abdominoperineal excision: analysis of the ACS NSQIP database

A. A. Althumairi, J. K. Canner, Susan L Gearhart, Bashar Safar, Sandy H Fang, E. C. Wick, Jonathan Efron

Research output: Contribution to journalArticle


Aim: The perineal wound following abdominoperineal excision (APR) is associated with a high complication rate. We aimed to evaluate the risk factors for wound complications and examine the effect of flap reconstruction on wound healing. Method: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was searched for patients who underwent APR for rectal adenocarcinoma. They were divided into two groups: primary closure of the perineal wound and flap reconstruction. A logistic regression analysis was performed to identify the risk factors for deep surgical site infection (SSI) and wound dehiscence. Results: A total of 8449 (94%) patients from the database underwent primary closure and 550 (6%) underwent flap reconstruction. Patients who underwent flap reconstruction had a longer operation time, a higher incidence of deep SSI, wound dehiscence, more blood transfusion requirement and a higher rate of return to the operating room (all P 2 (OR 1.7, P = 0.006), weight loss (OR 2, P 2 (OR 1.9, P = 0.001) and closure with a flap (OR 2.9, P 

Original languageEnglish (US)
Pages (from-to)O260-O266
JournalColorectal Disease
Issue number7
Publication statusPublished - Jul 1 2016



  • Abdominoperineal excision
  • flap reconstruction
  • rectal cancer
  • wound healing

ASJC Scopus subject areas

  • Gastroenterology

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