Local gentamicin application for perineal wound healing following abdominoperineal rectum excision

Article Abstract:

Patients with rectal or anal cancer may require abdominoperineal rectum excision, a procedure in which the anus and rectum are closed off and an artificial intestinal opening is established through the abdominal wall. A major complication of this extensive surgery is the development of local wound infection, particularly in the perineal area (area between the anus and scrotum or vagina). Up to 70 percent of patients who develop perineal wound infection will have secondary wound healing, perineal abscess and even septicemia (blood poisoning). Although the use of preventive antibiotics has reduced the rate of infection for other intestinal surgery, the same improvement has not been achieved for abdominoperineal resection patients. The main reason is that systemically administered antibiotics do not reach high enough concentrations in the wound tissue of the abdominoperineal ares. This is due to the impaired blood supply to the soft tissue of this area. A reduction in infection rate in bone and soft tissue surgery has been achieved using local application of gentamicin (gentamicin-polymethylmethacrylate) in the form of chains of beads placed within the wound. This provides release of high concentrations of antibiotics within the wound area over a period of days and weeks. A report is presented of the effectiveness of administering these gentamicin bead chains to patients who underwent abdominoperineal rectum excision. Patients were studied prospectively and were randomly assigned to receive either gentamicin beads or serve as controls (those who did not receive gentamicin beads). The two patient groups were similar. The group receiving gentamicin had a significantly higher rate of primary wound healing than the controls (87 percent, compared with 46 percent). The gentamicin group also had a significantly shorter postoperative hospital stay than the controls (20 days, compared with 27 days). These results indicate that gentamicin bead chains have a beneficial effect on local wound healing for patients who undergo abdominoperineal rectum excision. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Prevention, Surgical wound infections, Dosage and administration, Perineum, Polymethylmethacrylate, Polymethyl methacrylate, Gentamicin, Gentamicins

---

Postoperative adjuvant chemotherapy and radiotherapy for cancer of the large bowel and rectum

Article Abstract:

Forty patients suffering from cancer in regions of the large intestine and rectum (last section of the digestive tract, just before the anus) received chemotherapy and doses of radiation therapy below the maximum amount that body tissues can tolerate following surgery. With only two exceptions, this treatment was reserved for patients whose cancer had developed to certain specific stages. The treatment was well-tolerated and patients had longer periods free of disease when compared to patients with bowel cancers who had surgery alone. These findings are similar to those of the Gastrointestinal Tumor Study Group, which reported better long-term survival as a result of this treatment. Patients who received additional extended chemotherapy had at least as good a percentage of favorable outcomes. Patients whose tumors were above the point where the rectum leaves the membrane lining the abdominal cavity also had improved results. Additional studies should be conducted to evaluate the success of such therapies for cancer patients.

Physiological aspects, Radiotherapy, Chemotherapy

---

Synchronous carcinoma of the colon and rectum: prognostic and therapeutic implications

Article Abstract:

The authors studied close to one thousand diagnosed cases of cancer of the colon or rectum (colorectal carcinoma). Two percent had cancers of the colon and rectum simultaneously. These patients also had a higher occurrence of noncancerous (benign) tumors than other subjects. Patients with simultaneous tumors were more likely to have effected lymph nodes. The microscopic appearance of the glandular tumors was mucous-like. The five-year survival rate for the patients with simultaneous cancers was not different from individuals afflicted by a single cancer. Barium enema x-ray studies were found to be inconclusive and colonoscopic (the examination of the entire colon through the use of a fiber optic viewing instrument) was the preferred diagnostic method adopted. The authors suggest a conservative surgical approach.

Evaluation, Diagnosis, Colonoscopy, Cancer, Tumors

Similar abstracts:

• Abstracts: Central diabetes insipidus: a complication of ventriculoperitoneal shunt malfunction during pregnancy. Influence of maternal and fetal glucokinase mutations in gestational diabetes
• Abstracts: Unanticipated admission to the hospital following ambulatory surgery. Monitoring anesthetic care: new directions
• Abstracts: Demonstration of specific binding of cocaine to human spermatozoa. Migrainelike headache and cocaine use
• Abstracts: HIV infection following motor vehicle trauma in Central Africa. Pedestrian fatalities - New Mexico, 1958-1987
• Abstracts: Recommendations for the prevention of malaria among travelers. The spread of chloroquine-resistant malaria in Africa: implications for travelers

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.