Objective:

To provide a comprehensive assessment of the incidence, types, and management of wound complications following abdominoperineal resection (APR), with a specific focus on the role of prophylactic negative-pressure wound therapy (pNPWT) in preventing these complications.

Key Findings:

• Perineal wound complications occur in up to 50% of patients undergoing APR, with studies indicating varying rates based on specific patient factors.
• Factors contributing to high complication rates include preoperative radiotherapy, extensive resections, and comorbidities such as diabetes and obesity.
• pNPWT has shown promise in reducing surgical site infections (SSIs) and wound dehiscence in various surgical fields, though evidence specific to APR is limited.
• Early studies indicate pNPWT may improve wound healing times in APR, but pooled evidence remains scarce and further investigation is warranted.
• Inconsistent results across studies regarding the efficacy of pNPWT, with some reporting increased SSI rates, highlight the need for more rigorous research.

Interpretation:

While pNPWT may offer benefits in managing perineal wounds post-APR, further research is needed to establish its long-term efficacy, cost-effectiveness, and optimal application strategies, particularly in diverse patient populations.

Limitations:

• Scarcity of pooled evidence on the efficacy of pNPWT limits generalizability.
• Inconsistent results across literature regarding SSI rates necessitate caution in interpretation.
• The lack of established protocols for integrating pNPWT into postoperative care poses challenges for standardization and implementation.

Conclusion:

Further research is essential to determine the most effective implementation strategies for pNPWT in APR patients and to quantify its impact on patient outcomes.