Management of the pelvic space after proctectomy

Abstract

Closed-suction drainage with peritoneal and perineal suture has been used in 106 patients undergoing proctectomy for carcinoma or ulcerative or Crohn's colitis. This technique resulted in primary wound healing in 63 per cent of all the patients. Wound breakdown and delayed primary healing were particularly likely to occur in the young, in patients with Crohn's disease, in those who had contaminated wounds and in those on prolonged systemic steroid therapy. Even in the high-risk patients primary wound healing could still be achieved in 33 per cent. If haematoma or infection of the wound occurs the wound can be opened and the patient is no worse than if the wound had been packed initially.