Healing of the perineal wound after proctectomy for nonmalignant conditions

Abstract

A series of 62 patients was studied as regards healing of the perineal wound after proctectomy; 23 patients suffered from ulcerative colitis, 25 from Crohn's colitis, and 14 from polyposis coli. The overall results were in keeping with data from the literature: 73.9 per cent of wounds in patients with ulcerative colitis and 60 per cent of wounds in patients with Crohn's colitis were healed at six months. The worst results were obtained with packing of the perineal wound, especially in inflammatory bowel disease: 61 per cent of those wounds were not healed at six months. Superior results were obtained with conservative surgery, consisting of perirectal excision and intersphincteric resection. With this technique perineal wounds were not healed at six months in 13.6 per cent of patients with inflammatory bowel disease. In the treatment of persistent sinuses after proctectomy, curettage proved disappointing. Better results were obtained with excision of the sinus tract and primary closure of the resulting wound.