Indications for immediate tissue transfer for soft tissue reconstruction in visceral pelvic surgery

Background. Perineal wound complications may occur after visceral pelvic su rgery. TW reviewed our experience to determine indications for immediate ti ssue transfer (TT) to prevent complications. Methods. Hospital records and computerized data were re-viewed on 175 perin eal repairs in 156 patients treated at The University of Texas M.D. Anderso n Cancer Center for tumors involving the alimentary tract (135 of 175), gen itourinary tract (15 of 175), perineum (19 of 175), or sacrum (6 of 175). P atients had either resection of only the colorectum and anus (APR) (46 of 1 75) or multivisceral resection (MVR) (129 of 175), and the perineal wound w as closed by using TT (108 of 175) or primary closure (PC) (67 of 175) on t he basis of the surgeon's judgment. Complications were compared between PC and TT groups. Results. Complications occurred in 57% (100 of 175). There was no significa nt difference overall in PC and TT procedures or in the APR subgroup. There were significantly fewer complications for TT patients in the MVR subgroup (P = .0001). There were significantly fewer complications for TT patients with prior irradiation in both APR (P = .01) and MIR (P = .007) subgroups. Conclusions. Immediate TT for perineal wound closure is associated with few er heating complications than PC in a subset of patients with multivisceral resection or prior radiotherapy. Surgical planning in these cases should c onsider immediate soft tissue reconstruction.