Effect of local gentamicin-collagen on perineal wound complications and cancer recurrence after abdominoperineal resection: a multicentre randomized controlled trial

Colorectal Dis. 2013 Mar;15(3):341-6. doi: 10.1111/j.1463-1318.2012.03196.x.

Abstract

Aim: Perineal wound sepsis is a common problem after abdominoperineal resection of the rectum (APR), with a reported incidence of 10-15% in previously non-irradiated patients, 20-30% in patients given preoperative radiation and 50% among patients submitted to preoperative radiation combined with chemotherapy. The local application of gentamicin-collagen was evaluated to determine whether its use in the perineal wound reduced risk complications and had an effect on cancer recurrence.

Method: In this prospective multicentre (seven hospitals) randomized controlled trial, 102 patients undergoing APR due to cancer or benign disease were randomized into two groups including surgery with gentamicin-collagen (GS+, n = 52) or surgery without gentamicin-collagen (GS-, n = 50). Patients were followed at 7, 30 and 90 days and at 1 and 5 years.

Results: There were no statistically significant differences between the two groups regarding perineal wound complications, infectious or non-infectious, or cancer recurrence.

Conclusion: There was no statistically significant effect on perineal wound complications or cancer recurrence following the local administration of gentamicin-collagen during APR.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage
  • Collagen / administration & dosage*
  • Drug Combinations
  • Female
  • Follow-Up Studies
  • Gentamicins / administration & dosage*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / prevention & control*
  • Perineum / surgery
  • Peritoneal Lavage / methods*
  • Prospective Studies
  • Rectal Neoplasms / surgery*
  • Surgical Wound Infection / drug therapy*
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology
  • Sweden / epidemiology
  • Wound Healing*

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • Gentamicins
  • Collagen