Treatment of persistent perineal sinus with vaginal fistula following proctocolectomy for Crohn's disease

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Abstract
The utilization of a myocutaneous flap based on the gracilis muscle is described in two patients who had a persistent perineal sinus following proctocolectomy for Crohn's disease. In each case the posterior vaginal wall had eroded to form a fistula. This flap provided a cutaneous surface with good sensation to replace the posterior vaginal wall and tissue bulk to fill the excised cavity. A good functional result was obtained in each patient. This technique provides a useful contribution to the management of this unusual complication.