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High-vacuum drainage and primary perineal wound closure in abdominoperineal excision of the rectum.

The result of perineal wound healing after rectal excision with primary perineal closure by high-vacuum drainage was studied prospectively. High vacuum drainage was performed via a wide-bore catheter (Ch. 27) placed through a stabwound on the thigh. The method was applied in 114 of 127 patients who had abdominoperineal excision of the rectum (89.7 per cent). Contra-indications were inadequate haemostasis and pre-existing massive perineal sepsis. Primary perineal wound closure was present in 85.9 per cent of patients, delayed healing in 12.3 per cent and a perineal sinus developed in two patients (1.8 per cent).