Persistent perineal sinus following proctocolectomy in the inflammatory bowel disease patient
Abstract Prolonged perineal wound healing following proctocolectomy in patients with inflammatory bowel disease (IBD) is a frustrating result for the medical team and patients who were hoping for improved quality of life. Prolonged healing, which lasts more than 6 months following proctocolectomy, i...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-11-01
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| Series: | JGH Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jgh3.12983 |
| _version_ | 1827630856033796096 |
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| author | Sam D. Papasotiriou Gregory A. Dumanian Scott A. Strong Stephen B. Hanauer |
| author_facet | Sam D. Papasotiriou Gregory A. Dumanian Scott A. Strong Stephen B. Hanauer |
| author_sort | Sam D. Papasotiriou |
| collection | DOAJ |
| description | Abstract Prolonged perineal wound healing following proctocolectomy in patients with inflammatory bowel disease (IBD) is a frustrating result for the medical team and patients who were hoping for improved quality of life. Prolonged healing, which lasts more than 6 months following proctocolectomy, is termed persistent perineal sinus (PPS) and typically necessitates further surgical management. Healing of the PPS is difficult due to the resulting “dead space” following proctocolectomy, necessitating the need to fill the void with viable tissue in an area with anatomic constraints. Here we provide a narrative review and comprehensively address the incidence, pathogenesis, and clinical and operative management of a PPS in patients with IBD following proctocolectomy. Operative methods discussed include surgical debridement, flap closure of the perineum, omental flap closure, and gracilis muscle transposition. It is necessary to further investigate and establish a gold standard of care for these patients. |
| first_indexed | 2024-03-09T14:12:56Z |
| format | Article |
| id | doaj.art-9aa3e527b4dc4a8e92e30df85e2bbf22 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-03-09T14:12:56Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-9aa3e527b4dc4a8e92e30df85e2bbf222023-11-29T06:05:20ZengWileyJGH Open2397-90702023-11-0171174074710.1002/jgh3.12983Persistent perineal sinus following proctocolectomy in the inflammatory bowel disease patientSam D. Papasotiriou0Gregory A. Dumanian1Scott A. Strong2Stephen B. Hanauer3Northwestern University Chicago Illinois USANorthwestern University Chicago Illinois USANorthwestern University Chicago Illinois USANorthwestern University Chicago Illinois USAAbstract Prolonged perineal wound healing following proctocolectomy in patients with inflammatory bowel disease (IBD) is a frustrating result for the medical team and patients who were hoping for improved quality of life. Prolonged healing, which lasts more than 6 months following proctocolectomy, is termed persistent perineal sinus (PPS) and typically necessitates further surgical management. Healing of the PPS is difficult due to the resulting “dead space” following proctocolectomy, necessitating the need to fill the void with viable tissue in an area with anatomic constraints. Here we provide a narrative review and comprehensively address the incidence, pathogenesis, and clinical and operative management of a PPS in patients with IBD following proctocolectomy. Operative methods discussed include surgical debridement, flap closure of the perineum, omental flap closure, and gracilis muscle transposition. It is necessary to further investigate and establish a gold standard of care for these patients.https://doi.org/10.1002/jgh3.12983Crohn's colitisinflammatory bowel disease clinicalpersistent perineal sinusulcerative colitis |
| spellingShingle | Sam D. Papasotiriou Gregory A. Dumanian Scott A. Strong Stephen B. Hanauer Persistent perineal sinus following proctocolectomy in the inflammatory bowel disease patient JGH Open Crohn's colitis inflammatory bowel disease clinical persistent perineal sinus ulcerative colitis |
| title | Persistent perineal sinus following proctocolectomy in the inflammatory bowel disease patient |
| title_full | Persistent perineal sinus following proctocolectomy in the inflammatory bowel disease patient |
| title_fullStr | Persistent perineal sinus following proctocolectomy in the inflammatory bowel disease patient |
| title_full_unstemmed | Persistent perineal sinus following proctocolectomy in the inflammatory bowel disease patient |
| title_short | Persistent perineal sinus following proctocolectomy in the inflammatory bowel disease patient |
| title_sort | persistent perineal sinus following proctocolectomy in the inflammatory bowel disease patient |
| topic | Crohn's colitis inflammatory bowel disease clinical persistent perineal sinus ulcerative colitis |
| url | https://doi.org/10.1002/jgh3.12983 |
| work_keys_str_mv | AT samdpapasotiriou persistentperinealsinusfollowingproctocolectomyintheinflammatoryboweldiseasepatient AT gregoryadumanian persistentperinealsinusfollowingproctocolectomyintheinflammatoryboweldiseasepatient AT scottastrong persistentperinealsinusfollowingproctocolectomyintheinflammatoryboweldiseasepatient AT stephenbhanauer persistentperinealsinusfollowingproctocolectomyintheinflammatoryboweldiseasepatient |