Grafting the Unhealed Perineal Wound After Coloproctectomy for Crohn Disease

Anderson, Robin; Turnbull, Rupert B.

doi:10.1001/archsurg.1976.01360220031005

Cited by 47 publications

(7 citation statements)

References 3 publications

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“…Some have described ''saucerization,'' where excision of the sinus includes a thorough debridement and curettage to change the tunnel shape to a flat wound; skin grafting is performed immediately or as a delayed procedure. 55,56 Recently, a cleft closure, modified from a technique for treatment of pilonidal disease, has been described. [57][58][59] Branagan and colleagues achieved 100% successful healing in 8 patients using this procedure, which was performed as a same-day surgical procedure with local anesthesia.…”

Section: Treatment Of the Unhealed Perineal Woundmentioning

confidence: 99%

Management of Nonhealing Perineal Wounds

Genua

Vivas

2007

Clinics in Colon and Rectal Surgery

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The manifestations of perianal Crohn's disease vary from primary lesions such as skin tags and fissures, to diffuse septic destruction of tissue and sphincter muscle. These manifestations are often persistent and refractory to surgical treatment; however, a more disappointing scenario is when the treatment itself results in a chronic wound. The ideal approach for management involves basic surgical principles, careful patient selection, and realistic expectations. Choice of appropriate procedure, effective elimination of sepsis, thorough evaluation to rule out concomitant systemic disease, and appropriate use of fecal diversion are each an important principle. If proctectomy is necessary, several strategies such as intersphincteric dissection, avoidance of fecal contamination, and appropriate wound closure, are effective in diminishing the postoperative morbidity of an unhealed perineal wound. When an unhealed perineal wound develops in a patient with Crohn's disease, the initial management is conservative. When surgical treatment is necessary, success depends on careful patient selection, optimizing the patient's condition, elimination of sepsis, and choice of an effective technique for healing.

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Section: Treatment Of the Unhealed Perineal Woundmentioning

confidence: 99%

Management of Nonhealing Perineal Wounds

Genua

Vivas

2007

Clinics in Colon and Rectal Surgery

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“…In the quest for the best treatment of PPS, studies with longer follow-up and larger numbers are undoubtedly required. However, this would be difficult as the numbers going through an individual unit are often small with the largest series comprising 48 patients only [15] . Further, follow-up probably requires to be at least 5 years to capture recurrence [14] whereas the majority of the series published currently has a follow-up period of less than three years, and thus preliminary reports are valuable.…”

Section: Discussionmentioning

confidence: 99%

Karydakis flap for post-proctectomy perineal sinus: A case series and review

Moyes

Telfer

et al. 2016

International Journal of Surgery Case Reports

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HighlightsPersistent perineal sinus is a troublesome and common complication post-proctectomy.Treatment can be simple and ineffective or complex but relatively successful.Karydakis procedure is a treatment for pilonidal sinus and has never been reported to be used to treat persistent perineal sinus.Two cases, both suffered from Crohn’s disease and persistent perineal sinus, had complete healing with no short term recurrence after Karydakis procedure.

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“…Moreover, epithelial autografts offered little promise in repairing the depth of the defect without mechanical and functional dermal support, as suggested by poor skin graft take in perineal sinus studies. In a series of 48 patients undergoing skin grafting for marsupialized sinus tracts, Anderson and Turnbull 16 reported healing in only 20% of tracts. The use of bilayered and cellular dermal replacements for chronic wounds is promising.…”

Section: Discussionmentioning

confidence: 99%