title: Pedicled flaps in the treatment of nonhealing perineal wounds.
abstract: BACKGROUND
  A persistent sinus is an annoying complication following proctectomy. We examined the experience of a single colorectal surgeon in treating this condition using pedicled flaps.
  
  
  METHODS
  Case note review of all patients undergoing gracilis muscle transposition, Rectus abdominis muscle flap or omental flap for persistent perineal sinus.
  
  
  RESULTS
  Seventeen patients were identified: seven had gracilis muscle transposition, eight had omental transposition and two had a rectus abdominis flap. 13/17 patients who underwent a flap had a persistent sinus following proctectomy for Inflammatory bowel disease. Four patients who had a gracilis muscle transposition achieved healing. Seven out of eight patients had good results with omental transposition. One patient did well after a rectus abdominis flap.
  
  
  CONCLUSIONS
  A gracilis transposition is a relatively simple operation with minimal morbidity useful for superficial sinuses not requiring a muscle bulk. A rectus abdominis flap is a more complex specialized procedure with better results especially in dealing with larger cavities but it may compromise future stoma sites. Omentoplasty has excellent results, but is only available in some patients.
authors.affiliation: Department of Surgery, Queen Elizabeth Hospital, Edgbaston, UK. achyuthm@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Menon
authors.forename: M A
authors.initials: MA
authors.lastname: Clark
authors.forename: T
authors.initials: T
authors.lastname: Shatari
authors.forename: C
authors.initials: C
authors.lastname: Keh
authors.forename: M R B
authors.initials: MR
authors.lastname: Keighley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D009852:Omentum / Q000637:transplantation*; D010502:Perineum / Q000601:surgery*; D017568:Rectus Abdominis / Q000637:transplantation; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology