Persistent Perineal Sinus: Incidence, Pathogenesis, Risk Factors, and Management

Overview

Journal Surg Today

Specialty General Surgery

Date 2009 Mar 13

PMID 19280276

Citations 13

Authors

Varut Lohsiriwat

Affiliations

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Abstract

This review discusses the incidence, pathogenesis, risk factors, diagnosis, and therapeutic options for persistent perineal sinus (PPS), defined as a perineal wound that remains unhealed more than 6 months after surgery. The incidence of PPS after surgery for inflammatory bowel disease (IBD) ranges from 3% to 70% and after abdominoperineal resection (APR) for low rectal cancer, it can be up to 30%. These unhealed wounds are frequently related to perioperative pelvic or perineal sepsis. Crohn's disease (CD) and neoadjuvant radiation therapy are also important risk factors. The management of PPS is based on an understanding of pathogenesis and clinical grounds. The advantages and disadvantages of the current therapeutic approaches, including the topical administration of various drugs, vacuum-assisted closure, and perineal reconstruction with a muscle flap or a myocutaneous flap are also discussed.

Citing Articles

Persistent perineal sinus following proctocolectomy in the inflammatory bowel disease patient.

Papasotiriou S, Dumanian G, Strong S, Hanauer S JGH Open. 2023; 7(11):740-747.

PMID: 38034049 PMC: 10684985. DOI: 10.1002/jgh3.12983.

Is a coupled to the suitable for urethral-perineal reconstruction? Considerations about a relapsing urethral-cutaneous fistula condition.

Borgognone A, Santi G, Baffigo G, Capobianco S, Goletti S JPRAS Open. 2023; 38:91-97.

PMID: 37745010 PMC: 10514385. DOI: 10.1016/j.jpra.2023.08.002.

Endoscopic electrocauterization for management of chronic perineal sinus following abdominoperineal resection.

Larson B, Azizi S, Ma T J Surg Case Rep. 2022; 2022(5):rjac194.

PMID: 35592457 PMC: 9113013. DOI: 10.1093/jscr/rjac194.

Interdisciplinary Surgical Approaches in Vaginal and Perineal Reconstruction of Advanced Rectal and Anal Female Cancer Patients.

Horch R, Ludolph I, Cai A, Weber K, Grutzmann R, Arkudas A Front Oncol. 2020; 10:719.

PMID: 32477947 PMC: 7237715. DOI: 10.3389/fonc.2020.00719.

Perineal reconstruction using an inferior gluteal artery perforator flap after abdominoperineal resection.

Nico Albano M, Louro J, Brito I, Ramos S BMJ Case Rep. 2019; 12(9).

PMID: 31537601 PMC: 6754658. DOI: 10.1136/bcr-2018-228613.

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