Evidence map›Paper›PMID 40632350›Full record

ArticleLangenbeck's archives of surgery2025

Reconstruction of the perineal defect after abdominoperineal resection with vertical rectus abdominis myocutaneous (VRAM) flap versus primary direct closure - a single center retrospective cohort study.

Georgi Kalev, Sylvia Buettner, Mohamad El-Ahmar, Christoph Reissfelder, Steffen Seyfried, Georgi Vassilev, Julia Hardt

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Langenbeck's archives of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Georgi KalevDepartment of Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany. georgi.kalev@yahoo.com.
Sylvia BuettnerDepartment of Biometry and Statistics, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany.
Mohamad El-AhmarDepartment of Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany.
Christoph ReissfelderDepartment of Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany.
Steffen SeyfriedDepartment of Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany.
Georgi VassilevDepartment of Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany.
Julia HardtDepartment of Surgery, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167, Mannheim, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe closure of the perineal defect following pelvic surgery that includes abdomino-perineal resection (APR) can often be challenging and remains an important issue given the reported high wound morbidity. The vertical rectus abdominis myocutaneous (VRAM) flap, which was proposed in the past as an alternative to direct closure (DC), enables the reconstruction of extensive perineal wounds.

methods184 consecutive patients who underwent abdominoperineal resection at tertiary university institution between January 2014 and June 2024 were included in this retrospective analysis. The aim of the study was to evaluate the outcomes of perineal wound reconstruction using a VRAM flap (n = 29) compared to DC (n = 155).

resultsThe rate of overall perineal and abdominal wall wound complications did not differ significantly (p = 0.321 and p = 1.000, respectively). However, significantly more pelvic abscesses requiring CT-guided percutaneous drainage were observed in the DC-group (p = 0.048). Subgroup analysis of patients who underwent radiochemotherapy prior to surgery revealed lower incidence of severe perineal complications after VRAM flap reconstruction of the perineal defect (p = 0.037).

conclusionThe VRAM flap has proven to be a safe technique and should be considered especially for the reconstruction of extensive perineal defects following pelvic surgery.

Indexed as

Myocutaneous FlapPerineumPlastic Surgery ProceduresProctectomyRectal NeoplasmsRectus AbdominisAgedFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTreatment OutcomeAbdominoperineal resectionPelvic abscessPelvic surgeryVRAM

Identifiers

PMID40632350
PMCPMC12241187

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.