Management of the perineal wound after rectal excision for neoplastic disease

Publisher Website
Google Scholar
Abstract
Two methods of management of the perineal wound after rectal excision for neoplastic disease were compared in a prospective randomized clinical trial in 65 patients. Group A was (28 patients) was treated by partial closure of the perineal wound and cigarette drainage of the pelvic space, according to the method proposed by Gabriel. Group B (37 patients) was treated by complete suture of the perineal wound and suction drainage of the pelvic space according to the method proposed by Altemeier. Immediate and late results were better in patients in group B. They achieved healing per primam in 62.85% of cases and had significantly shorter hospital stays than patients in group A. Three months postoperatively, 91.42% of patients in group B and 59.25% of those in group A had complete healing of the perineal wounds, with a statistically significant difference (.chi.2 with Yates correction = 7.27, P < 0.01). The development in 10 patients of group B of perineal abscesses or hematomas necessitated reopening of the perineal wounds: however, the postoperative courses were similar to those of patients in group A. Healing by primary intention with use of the method described is the treatment of choice for managing the perineal wounds in patients undergoing rectal excision for neoplastic disease.