Surgery Today

, Volume 39, Issue 3, pp 189–193 | Cite as

Persistent perineal sinus: Incidence, pathogenesis, risk factors, and management

  • Varut Lohsiriwat
Review Article


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.

Key words

Pathogenesis Persistent perineal sinus Risk factors Treatment 


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Copyright information

© Springer 2009

Authors and Affiliations

  • Varut Lohsiriwat
    • 1
  1. 1.Department of Surgery, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand

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