Combined prophylactic negative-pressure wound therapy and preoperative oral antibiotics reduce perineal wound complications after abdominoperineal resection.

PURPOSE: Perineal wound complications after abdominoperineal resection (APR) remain a major concern, often leading to poor patient outcomes. Prophylactic negative-pressure wound therapy (pNPWT) and oral antibiotics (OA) administration have individually shown promise in reducing surgical site infections (SSIs). The present study investigated their combined effect for the prevention of perineal wound complications after APR. METHODS: This retrospective study included patients who underwent APR for lower rectal cancer between April 2016 and March 2025. Patients were divided into two groups: conventional treatment (CT) and those receiving a combination of pNPWT and preoperative OA (pNPWT + OA). Postoperative complications were compared. RESULTS: Sixteen patients were included in the pNPWT + OA group and 14 in the CT group. The incidence of superficial perineal SSIs was significantly lower in the pNPWT + OA group than in the CT group (6.3% vs. 42.9%, p = 0.030), with no cases of wound dehiscence (0% vs. 28.6%, p = 0.036). Furthermore, preoperative albumin < 3.0 g/dL correlated with the incidence of perineal SSIs and wound dehiscence. CONCLUSION: The combined use of pNPWT and OA was associated with a reduction in perineal wound infections and dehiscence following APR. This approach may improve postoperative outcomes; however, these findings are hypothesis-generating and should be validated in large-scale, prospective studies, including cost-effectiveness analyses.