Perineal Wound Research Articles

The clinical progression and wound healing rate of dehisced perineal tears healing by secondary intention: A prospective observational study

ObjectivesTo establish the clinical progression of dehisced perineal wounds healing by secondary intention and to investigate the incidence and factors associated with delayed healing. MethodsSecondary analysis of women with perineal wound dehiscence recruited into the PERINEAL study between August 2020- August 2021 (NCT 04480684). Three-dimensional wound measurements were taken with the Silhouette® camera. Significant bacterial colonisation was diagnosed using the MolecuLight i:X camera. As it is agreed that acute wounds should heal sufficiently within four weeks, diagnosis of delayed wound healing was made if a wound took longer than four weeks to heal. A wound was deemed to have healed if there was complete wound closure, with no evidence of granulation tissue or signs of infection on clinical examination. Results55 women with perineal wound dehiscence participated. Wounds took an average of 3 weeks to heal (range 1–16) and 38 (69.1%) wounds healed in ≤ 4 weeks from the first clinical review. 17 (30.9%) wounds had significant bacterial colonisation, identified on bacterial fluorescence imaging.Women with a wound area of < 1.60 cm2 or wound perimeter of < 5.57 cm had a 70% probability of wound healing in ≤ 4 weeks. 47.1% of wounds with significant bacteria colonisation healed within 4 weeks, in comparison to 78.9% of wounds not colonised (p = 0.03). 25.0 % (n = 2) of wounds with OASI healed within 4 weeks, in comparison to 76.5% (n = 36) of wounds with no OASI (p = 0.02). Bacterial fluorescence (OR 0.21 (0.05–0.87)) and OASIs (OR 0.09 (0.01–0.66)) were independent risk factors associated with delayed wound healing. The model including wound area, fluorescence and OASIs had the greatest AUC (0.81, 95% CI 0.67–0.94) indicating the best predictive model. ConclusionsThis is the first study to describe healing outcomes of dehisced perineal wounds and factors associated with delayed healing. The study findings will help clinicians counsel women effectively and tailor follow-up care at the first assessment, based on individual risk factors.

The Effectiveness of Infusa Leaf of Binahong (Anredera Codifolia) in Healing Perineal Wound

Perineal wound is a tear in the birth canal (perineum) that occurs both in spontaneous labor and episotomy. Perineal wounds that take a long time to heal can cause infection and contribute to maternal death. Binahong leaf (Anredera cordifolia) can be used as an alternative for perineal wound healing because it contains several chemical compounds, namely flavonoids, oleanolic acid, protein, saponins and ascorbic acid. The content of ascorbic acid in this plant is important for activating the enzyme prolyl hydroxylase which supports the hydroxylation stage in the formation of collagen, so that it can accelerate the wound healing process. The purpose of this study was to determine the effectiveness of Binahong Leaf Infusion (Anredera Cordifolia) on perineal wound healing in postpartum mothers at Balowerti Health Center in 2022.&#x0D; The design in this research is Quasi Experiment. The population of this study were all post partum mothers at Puksemas Balowerti in April 2022 . The sample from this study amounted to 32 respondents divided into 16 respondents in the control group and 16 respondents in the intervention group using the purposive sampling technique. Data were taken using an observation sheet and analyzed using the Man-Whitney test.

Hubungan pengetahuan ibu nifas dengan perawatan luka perinium di PMB Aan Dyah Tahun 2020/2021

The cause of maternal death in Indonesia is still dominated by bleeding (32%) and hypertension in pregnancy (25%), followed by infection (5%), old partus (5%), and abortion (1%) in addition to obstetric causes, maternal mortality is also caused by other causes (non obstetric) of 32%. As a result of improper perineal care can result in perineal conditions affected by lokchea and moisture will greatly support the proliferation of bacteria that can cause infections in the perineum. The purpose of this study to determine the relationship of maternal knowledge with perineal wound at PMB Aan Dyah.&#x0D; This research use analytical method by using primary data and secondary data. The population in this study is the number of mothers in the last 3 months totaling 65 respondents in June - August 2017. Sampling technique is total sampling.&#x0D; The result of the research was obtained, good postpartum mother as many as 25 people (38,5%), bad woman with bad knowledge about 40 people (61,5%), postpartum who do perineal wound care 15 respondents (23,1%), and postpartum mothers who did not perform perineal wound care as much as 50 respondents (76.9%). In chi square test to see the correlation between knowledge of postpartum mother and perineal wound care, p-value value of0.000 (p &lt;0,05) was obtained, meaning that there was a significant correlation between maternal knowledge with perineal wound care. It is suggested to health officer to give counseling about perineal wound care on postpartum so that postpartum mother can know the importance of perineum wound care benefit.

Outcomes of perineal reconstruction with inferior gluteal artery myocutaneous flaps and primary closure following abdominoperineal resection.

Perineal wound morbidity following abdominoperineal resection (APR) is a significant challenge. Myocutaneous flap-based techniques have been developed to overcome morbidity associated with perineal reconstruction. We reviewed outcomes for patients undergoing APR in a hospital that performs inferior gluteal artery myocutaneous (IGAM) island transposition flaps and primary closure (PC) for perineal reconstruction. A retrospective study of patients who underwent APR for malignancy between January 2012 and March 2020 was performed and outcomes between IGAM reconstruction and PC compared. Primary outcomes were wound infection and dehiscence. Secondary outcomes included return to theatre, operative time, length of stay, flap loss and perineal hernia incidence. One-hundred and two patients underwent APR, with 50 (49%) who had PC and 52 (51%) had IGAM flap reconstructions. There were no differences between each group with regards to wound infection (23 vs. 22%, P=0.55) or wound dehiscence (25 vs. 24%, P=0.92). Thirteen (25%) IGAM patients required a return to theatre compared to three PC patients (6%) (P=0.008). IGAM procedures required twice the overall operative time (506 vs. 240 min, P=0.001) with no differences between groups when comparing the APR component (250 vs. 240 min, P=0.225). The IGAM group had a longer length of stay (median 13 days vs. 9 days, P=0.001). Only one IGAM flap was lost and no symptomatic hernias were identified. Perineal closure technique did not affect the incidence of wound infection or dehiscence. Closure technique should be tailored to underlying patient characteristics and surgical pathology.

THE ROLE OF GIVING VIRGIN COCONUT OIL FOR HEALING PERINEUM WOUNDS IN POST-PARTUM MOTHERS

Background: The process of childbirth can cause perineal injuries. Efforts are being made in healing perineal wounds with standard techniques of normal delivery care. The latest developments in wound care such as the provision of Virgin Coconut Oil (VCO) can accelerate the wound healing process.&#x0D; Objective: This study aims to determine the effect of giving Virgin Coconut Oil on perineal wound healing in post partum mothers.&#x0D; Methods: This type of research is a quantitative experiment with a quasi-experimental design. The population was post partum mothers as many as 30 people consisting of an intervention group of 15 people with VCO administration and a control group of 15 people with standard techniques of normal delivery care. Data were obtained using an observation sheet with an observation time of 6 days on wound healing and analyzed using an independent T-test.&#x0D; Results: The results showed that the healing time of perineal wounds with the standard technique of Normal Childbirth Care averaged 8 days. There is an effect of giving VCO on the duration of perineal wound healing with an average speed of healing for 6 days.&#x0D; Conclusion: It was found that there was an effect of giving Virgin Coconut Oil on the healing of perineal wounds in post partum mothers.&#x0D; Keywors : Virgin Coconut Oil, Perineum Wound, Post Partum

Effect of betel leaves decoction on the healing of perineum wounds in postpartum mothers at the maternity health center in Demak District, Demak Regency

Background : Perineal wound is a wound in perineal area naturally caused by episitomy. Injury to the perineum during childbirth causes the need for a proper treatment so that the injured can recover soon. The purpose of this study was to determine the effect of betel leaf decoction on the healing of perineal wounds in postpartum mothers. Methods : This study was carried out using Quasi Experimental research and post test with control group design of the intervention group and the control group. Meanwhile, the sampling technique used was the consecutive sampling method using the mann whitney test. Result : The intervention group which used betel leaf at fast category was 9 people (60.0%), medium category was 5 people (33.3%) and slow category was 1 person (6.7%). Meanwhile, the control group did not use betel leaf at the slow category was 10 people (66.7%), while those who were at the medium category was 5 people (33,3%). Conclution : The results showed that p value obtained was 000 (&lt; 0.05), thus Ho is rejected and Ha is accepted, indicating that there was an effect of betel leaf decoction on the healing of perineal wounds in postpartum mothers.

Transperineal pelvic drainage combined with lateral position to promote perineal wound healing after abdominoperineal resection: A prospective cohort trial.

Background:For the rectal cancer <5 cm from anal margin, extralevator abdominoperineal resection (eAPR) has been accepted widely by surgeons. However, the rate of perineal infection following up eAPR is approximately 70%. We did the study with the aim of evaluating the effect and safety of transperineal pelvic drainage combined with lateral position (TPDLP) on perineal wound in patients undergoing eAPR.Methods:Patients were randomly assigned to N-TPDLP group (standard arm) or TPDLP group (intervention arm). In the standard arm, surgery was completed after abdominal drainage tube was placed in pelvic. Comparatively, an additional transperineal wound drainage tube was applied in the experimental arm. Postoperatively, patients of both 2 groups were informed not to sit to reduce perineal compression until the perineal wound healed. But lateral position was demanded in the intervention arm. The primary endpoint was the rate of uncomplicated perineal wound healing defined as a Southampton wound score of <2 at 30 days postoperatively. Patients were followed for 6 months.Results:In total, 60 patients were randomly assigned to standard arm (n = 31) and intervention arm (n = 29). The mean perineal wound healing time was 34.2 (standard deviation [SD] 10.9) days in TPDLP arm, which significantly differ from 56.4 (SD 34.1) in N-TPDLP arm (P = .001). At 30 days postoperatively, 3 (10%) of 29 patients undergoing TPDLP were classified into grade 4 according to Southampton wound score, however, 16 (52%) of 31 patients were classified into grade 4 in control arm, and significantly difference was observed between randomization groups (P = .001). What's more, perineal wound pain was assessed at 30 days postoperatively, and it is discovered that the pain degree of patients in control arm was significantly more severe than the interventive arm (P = .015).Conclusion:In the present study, we found that TPDLP generated a favorable prognosis for perineal wounds with acceptable side-effects.

Perineal wound healing after abdominoperineal resection for rectal cancer: a retrospective cohort study.

Delayed perineal wound healing is a common complication after abdominoperineal resection (APR) in rectal cancer. The primary aim of this study was to evaluate the number of patients with delayed wound healing after APR. Secondary aims were to identify risk factors, and describe treatment. Prospectively collected data from the Swedish Colorectal Cancer Registry (SCRCR) was used for retrospective analysis of APR performed at Skåne University Hospital Malmö between 2013 and 2018. Medical charts were retrospectively reviewed. Delayed healing was defined as non-healed perineal wound 30days postoperatively. Patients undergoing extralevator APR requiring reconstruction were excluded. Statistical analysis was made using SPSS. Risk factors for impaired wound healing were analyzed using a multivariable model. A total of 162 patients were included, of which 114 underwent standard APR (sAPR) and 48 patients intersphincteric APR (isAPR). In the total population, 69% (111/162) were male, with median age 71 (26-87). The overall healing rate was 52% (85/162); 44% (50/114) in sAPR vs 73% (35/48) in isAPR (P < 0.001). Risk factors for impaired healing after multivariable analysis were BMI > 30 (OR 7.0; CI 95% 1.8-26.2, P = 0.004), reoperation (OR 7.9; CI 95% 1.6-39.8, P = 0.013), neoadjuvant radiotherapy (OR 5.2; CI 95% 1.02-25.1, P = 0.047) and sAPR (OR 2.598; CI 95% 1.05-6.41, P = 0.038). Eight percent (13/162) required an intervention (Clavien-Dindo ≥ 3). Delayed perineal wound healing is a frequent complication after APR but the majority could be treated conservatively. Several risk factors were identified. Further studies aiming at interventions reducing delayed perineal wound healing after APR are warranted.

The Effectiveness of Green Betel Leaf (Piper betle Linn) on Perineal Wound Healing: A Literature Review Study

The perineal injury during delivery can increase the risk of infection in postpartummothers. This paper reviews the effectiveness of green betel leaf (Piper betle Linn) onperineal wound healing. It was a literature review study. The first literature review stagewas to determine the problem using PICO questions. Then, search and collectdata/literature with the following steps: write keywords in the journal database andchoose articles according to the specified criteria. The databases were Google Scholar,Science Direct, and Technology Index (SINTA), and PMC. The population was nationaljournals examing the effectiveness of betel leaf on perineal wound healing. In addition,inclusion criteria were national journals researching the effectiveness of betel leaf onperineal wound healing and published from 2015 to 2020. Meanwhile, the exclusioncriteria were journals with no full text. The journal searching was carried out from 1 to20 August 2020. Data analysis used the following methods: critical appraisal, skimming,scanning, separating irrelevant articles from relevant articles, reading relevant articles,and making notes or summaries. Then we arranged publications in the table andanalyzed them. There were seven relevant journals from Google Scholar. The findingsshowed that betel leaf was effective for perineal wound healing. The betel leaf containsan antiseptic five times stronger than ordinary phenol. It also contains saponins thattrigger collagen formation for wound healing. Future researchers should examine thedegree of the perineal wound and explain the processing of betel leaf in detail.

To Summarize and Analyze the Epidemiological Characteristics and Prognostic Risk Factors of Patients with Pelvic Fracture Complicated with Perineal Injury.

This study is aimed at summarizing and analyzing the epidemiological characteristics and prognostic risk factors of patients with a pelvic fracture with perineal injury. The clinical data of 153 patients with pelvic fracture with perineal injury treated in our hospital from January 2012 to June 2021 were analyzed retrospectively. The data of sex, age, injury mechanism, pelvic fracture type, shock index (SI), perineal wound depth, concomitant injury, total hospital stay, and death were collected by the electronic medical record system. Among the 153 patients, there were 94 males and 59 females, with an average age of (43.2 ± 16.8) years. The cases were mainly concentrated into two age groups: 20–29 years old and 50–59 years old. In a year, pelvic fractures were mainly concentrated in 1–2 months and 11–12 months. In terms of injury time, there were mainly two periods of time in a day: 10 : 00～12 : 00 and 15 : 00～18 : 00. The MOTS-RTS scores of the patients in the undead group and the dead group were (7.12 ± 1.52), (2.69 ± 0.96), ISS scores were (27.36 ± 15.84), (61.32 ± 7.08), GCS scores were (12.84 ± 3.69), (4.13 ± 1.25), APACH II scores were (12.87 ± 8.84), (32.41 ± 6.98), and SOFA scores were (6.68 ± 5.87), (17.12 ± 3.12). The MOTS-RTS and GCS scores of the nondeath group were significantly higher, while the ISS score, APACH II score, SOFA score, and shock index were significantly lower. The overall mortality rate of 153 patients was 13.7%. The average area of perineal trauma in undead and dead patients was (54.5 ± 113.52) cm2 and (262.63 ± 300.84) cm2, respectively. The average depth of perineal trauma was (9.63 ± 7.22) cm and (16.23 ± 10.13) cm, respectively. The larger the area of perineal injury and the deeper the depth of perineal trauma, the worse their prognosis. Cox multivariate analysis showed that complications, MOTS-RTS score, ISS score, GCS score, perineal trauma area, and perineal trauma depth were independent risk factors affecting the prognosis of patients with pelvic fracture with perineal injury. Most of the patients with pelvic fracture complicated with perineal injury are 20–29 years old and 50–59 years old. The more serious the perineal injury is, the higher the mortality is. The main causes of death are refractory hemorrhagic shock and infection.

Green Betel Leaf Water with Pure Honey Against Healing Perineum's Wounds Mother Postpartum

Many postpartum mothers die from perineal injuries. Perineal infection can occur if the perineal wound is not treated correctly and correctly. This study was conducted to assess the effectiveness of healing wounds perineum postpartum mothers using green betel leaves and pure honey. This type of research is pre-experimental using one pretest group-posttest design. The number of 20 samples is determined by purposive sampling. Intervention is done using betel leaf decoction water to rinse perineal wounds for one week. Water is made from 5 sheets of betel leaves boiled with 1000 millilitres of water for 30 minutes to 600 millilitres. Data collection uses observation sheets filled in before and after the intervention. Analysis of data using the McNemar test obtained the result of the P-value 0.021 with the meaning &lt;0.05. The results showed an effect of giving green betel leaf water and consuming pure honey to heal perineal wounds in postpartum mothers, so it is recommended that postpartum mothers suffering from perineal wounds use a decoction of green betel leaf water to rinse the perineum and consumption. Pure honey because of the benefits and content obtained in green betel leaves and pure honey in healing perineal wounds.

The Effect of Kegel Exercises on Perineal Wound Healing in Postpartum Mothers

The purpose of this study was to determine the effect of Kegel exercises on the healing of perineal wounds in postpartum mothers at the Niar Pratama Clinic and the Citra Pratama Clinic, Deli Serdang Regency. The design used in the study was a quasi-experimental method with a static group comparison, which is a type of research to determine the effect of an action on a group of subjects who received treatment, then compared it with a group that did not receive treatment. This research was conducted at the Niar Pratama Clinic and the Citra Pratama Clinic, Deli Serdang Regency which was carried out in November 2019 - November 2020. The sampling design was based on purposive sampling, namely postpartum mothers with perineal injuries of degree I. The number of samples was 60 people who received treatment 30 people, while the control group was 30 people. Data analysis was carried out after all data had been collected by re-examining all the questionnaires one by one and ensuring that all data had been filled in according to the instructions. Then provide a code for all the questions that have been asked to make it easier for researchers when tabulating and analyzing data. Data were tabulated and analyzed using the Median Test (Mann-Whitney U-Test) with a significance level of &lt; 0.05. The results of this study are that there is a difference in wound healing in post partum mothers who do Kegel exercises when compared to mothers who do not do Kegel exercises with a difference of 18.76 points and there is an effect of Kegel exercises on perineal wound healing in postpartum mothers at the Pratama Niar Clinic and Pratama Clinic. Image of Deli Serdang Regency.

Robot-assisted laparoscopic abdominoperineal resection with en bloc prostatectomy using the Retzius-sparing robot-assisted radical prostatectomy technique.

The best surgical technique for rectal cancer invading the prostate remains controversial. Rectal resection with en bloc prostatectomy using a standard retropubic approach is an option but has disadvantages. We report a new surgical procedure applying Retzius-sparing robot-assisted radical prostatectomy. First, the rectum was mobilized mainly at its dorsal side. Next, the prostate was separated from the bladder and urethra via the pouch of Douglas approach without opening the Retzius cavity, after which the surgical specimen was extracted through the perineal wound. Lateral pelvic lymph node dissection was performed after vesicourethral anastomosis. This new robotic procedure minimizes surgical trauma and preserves normal pelvic anatomy. Furthermore, this approach makes it easy to perform subsequent lateral pelvic lymph node dissection.

Management of Perineal Wounds Following Pelvic Surgery.

Despite advancements in understanding and technique, there remain significant challenges in the management of a complex perineal wound following pelvic surgery. Complications including wound sepsis, fistulation, persistent sinus, and herniation produce additional morbidity and health care costs. This article details the methods of optimizing patient and operative factors to mitigate this risk, alongside strategies to deal with sequelae of wound failure.

Penerapan Rebusan Air Daun Binahong Untuk Mempercepat Penyembuhan Luka Perineum Pada Ibu Post Partum

The World Health Organization (WHO), reports that as many 25% of MMR occur due to post partum problems.The direct factor causing the high AKI is post partum hemorrhage (45%). Post partum is the postpartum period which starts from the time the baby is born and the placenta of the baby is born so that the womb returns to what it was before pregnancy which lasts for six weeks. Post partum hemorrhage due to the opening of blood vessels in the uterus during pregnancy due to the perineal wound can cause infection, Non-pharmacological management that can be given to accelerate the healing of perineal wounds is to use binahong leaf water boiled. To find out the application of giving binahong leaf water boiled to accelerate the healing of perineal wounds in post partum mothers. This study uses a literature review study that uses literature sources in the form of books, scientific articles, especially those that have been published. By using a search through the Google Scholar database from 2015-2020. Research result Shows that there is a significant effect on the application of giving binahong leaf water boiled to accelerate the healing of perineal wounds in post partum mothers. The application of boiled water from binahong leaves is more effective in accelerating the healing of perineal wounds in post partum mothers.

Hubungan antara Pengetahuan, Dukungan Keluarga dan Personal Hygiene dengan Perawatan Luka Perineum Masa Nifas di Wilayah Kerja Puskesmas Belida Darat Kecamatan Darat Kabupaten Muara Enim Tahun 2021

Perineal care is an effort to provide fulfillment of the need for comfort by nourishing the area between the two thighs which is limited between the anal canal and the external genitalia in women who have given birth to avoid infection. The prevalence of childbirth mothers who experience perineal rupture in Indonesia in the age group of 25-30 years is 24% and at the age of 32-39 years is 62%. In 2013 57% of mothers received perineal sutures (28% due to episiotomy and 29% due to spontaneous tears). To determine the relationship between knowledge, family support and personal hygiene with postpartum perineal wound care in The Working Area of the Belida Darat Health Center, Belida Darat District, Muara Enim Regency. This research is an analytical survey quantitative research with a cross sectional approach, namely research with observations in a period and research subjects are observed once during the study. The results of the chi-square statistical test of the knowledge variable obtained value = 0.002, personal hygiene variable obtained value = 0.023, and the family support variable obtained value = 0.025 this indicates there is a significant relationship between family support and perineal wound care in the Region Belida Darat Health Center in Belida Darat K . District Muara Enim Regency in 2021.

A comparison analysis of perineal wound complication after abdominoperineal extirpation (literature review)

At the moment, there is no consensus on such important issues for the practicing physician as the choice of the type of abdominoperineal resection and the optimal way to close the perineal defect. The review presents the data on the incidence of perineal wound complications after the use of various types of rectal extirpation and various types of perineal defect closure. The inconsistency of the data makes it necessary to conduct further randomized studies.

NON PHARMACOLOGICAL MANAGEMENT OF PERINEAL WOUNDS IN POST PARTUM : A REVIEW OF LITERATURE

Most of the women who gave birth spontaneously experienced tears in the perineum, if not treated properly, it can slow wound healing, increase the size and depth of the wound which can lead to post partum infection. One of the ways to accelerate the healing of perineal wounds is by non-pharmacological management. This literature review aims to analyze the non-pharmacological management of perineal wounds in postpartum mothers. The database used is Google scholar, PubMed, and Scientdirect with the keywords: post partum OR post partum AND non-pharmacological wound care OR nonpharmacological intervention OR treatment OR therapy AND perineal wound OR perineal wound healing. Inclusion criteria used: articles published in the last 5 years, RCT method or quasi experiment or experiment, primary research and full text available. The search results were obtained from Google scholar 18,513 articles, PubMed 6 articles and Scientdirect 150 articles. After screening based on inclusion criteria obtained from Google scholar 8 articles, PubMed 1 article and Scientdirect 2 articles, then a feasibility study was carried out using The Joana Briggs Institute (JBI) and obtained 6 articles that met the requirements for analysis. The results of the analysis showed that several non-pharmacological treatments were effective in healing perineal wounds including the use of red betel leaf decoction, Kegel exercises, consumption of tamarind and turmeric water, the use of Hyperricum Perforatum oil, the use of Achillea Millefolium and Hypericum Perforatum ointment, and cold compresses. It is hoped that non-pharmacological management of perineal wounds will be an alternative to accelerate wound healing and prevent infection.

Analysis of Kegel Gymnastics and Lavender Aromatherapy on Perineal Wound Pain Intensity in Post Partum Mothers, Bujel Village, Mojoroto District, Kediri City

Background: A number of the efforts that have been done for reduce pain in mother postpartum with perineal laceration can done by pharmacological and non-pharmacological. However use by pharmacology often cause effect side and sometimes no own strength effects. This study aimed to analyze the effect of Kegel exercises and lavender aromatherapy on the intensity of perineal wound pain in postpartum mothers.Methods: This research is a pre-experimental. The population in this study were all postpartum mothers at PMB Novitasari, Amd., Keb as many as 39 postpartum mothers for the period October 2019-31 January 2020. The sample in this study was all postpartum mothers at PMB Novitasari, Amd., Keb with simple sampling technique. Random Sampling. The test used is Chi-Square.Results: results showed that most (63.9%) of the respondents had pain intensity in the severe category before being given Kegel exercises and lavender aromatherapy, namely 23 people and almost half (47.2%) of the respondents had moderate pain intensity after being given Kegel exercises and lavender aromatherapy, namely 17 people.Conclusion: effect of giving Kegel exercises and lavender aromatherapy on the intensity of pain in pregnant women, while in this study there was a negative rank of 27 which means pain intensity. after being given kegel exercises and lavender aromatherapy decreased compared to pain intensity before being given kegel exercises and lavender aromatherapy

Early post-operative perineal wound complications in patients undergoing etralevator abdominoperineal excision: A Retrospective Study at Department of Surgical Oncology

Background: Extralevator Abdominoperineal Excision (ELAPE) is an emerging technique for the management of locally advanced distal rectal tumors in which sphincter preservation cannot be performed. The technique has not yet been adopted globally, however now as evidence is emerging more and more centers are adopting this technique. Positive circumferential margins (CRM) and intra-operative tumor perforations are one of the major factors that lead to local disease relapse and overall poor patient outcomes.