Ashley M Brown1 and Salah Rubayi1,2*
1 Division of Plastic and Reconstructive Surgery, Keck School of Medicine, USA 2 Department of Surgery, Rancho Los Amigos Hospital, USAFulltext PDF
Introduction: Traumatic wounds to the perineal and perianal area are associated with a high degree of morbidity and mortality. Patients remain at high risk for infection and manipulation of the anus and perianal tissue can lead to significant scarring and future functional impairment. Case Presentation: A 32-year-old male presents status motorcycle crash resulting in penetrating trauma to the perineum. After stabilization and primary anal repair, the patientís perianal wound was left open leading to painful dressing changes and anal retraction. Reconstruction was performed without complication using a combination of local muscle and fasciocutaneous flaps. Discussion: A wide range of treatment options are used to treat traumatic wounds of the perineal and perianal area. The best reconstructive plans address the risk for anal scarring, retraction and subsequent impairment by filling the dead space while providing well-vascularized support to the anal verge during wound closure. Conclusion: Reconstruction after fecal diversion with combined local muscle and fasciocutaneous flaps provides opportunity for wound closure and simultaneously prophylaxes against infection and anal retraction.
Perineal wound; Muscle flap; Reconstruction; Trauma
Brown AM, Rubayi S. Reconstructive Surgery of the Perineal and Anal Area after Trauma with Lower Extremity Flap. Clin Surg. 2020; 5: 2964.