Hartz R S, Poticha S M, Shields T W
Arch Surg. 1980 Apr;115(4):471-4. doi: 10.1001/archsurg.1980.01380040093016.
The operative management of the perineal wound of 100 consecutive patients undergoing abdominoperineal resection or total proctocolectomy was readily divided into four categories: (1) left open with simple packing, (2) closed primarily with simple drainage (Penrose or red rubber), (3) closed primarily with suction drainage (airtight and watertight), or (4) closed primarily with suction drainage plus continuous irrigation. At three weeks, none of the open wounds, 11% of those closed with simple drainage, 48% closed with suction, and 60% of those closed with suction plus irrigation were healed. By three months, the cumulative figures were 20%, 44%, 88%, and 87%, respectively, and at one year, 92%, 77%, 95%, and 97%. No difference was found between the wounds closed with suction and those closed with suction plus irrigation. There was a highly significant difference in the rate of wound healing when the wounds closed with suction alone or with irrigation were compared with those left open or closed with simple drainage. At three months, the former wounds were healed in 88% of the patients, and the latter in only 30%. The method of choice of management of the perineal wound appears to be that of primary closure with immediate suction drainage with or without concomitant irrigation.
对连续100例行腹会阴联合切除术或全直肠结肠切除术患者的会阴伤口进行手术处理，很容易分为四类：（1）敞开伤口，简单填塞；（2）一期缝合，简单引流（橡皮管或红色橡胶管）；（3）一期缝合，负压引流（气密且防水）；（4）一期缝合，负压引流加持续冲洗。三周时，敞开伤口无一愈合，简单引流缝合的伤口愈合率为11%，负压引流缝合的为48%，负压引流加冲洗缝合的为60%。到三个月时，累计愈合率分别为20%、44%、88%和87%，一年时分别为92%、77%、95%和97%。单纯负压引流缝合的伤口与负压引流加冲洗缝合的伤口之间未发现差异。单纯负压引流或加冲洗缝合的伤口与敞开或简单引流缝合的伤口相比，伤口愈合率有极显著差异。三个月时，前者伤口88%的患者愈合，后者仅30%愈合。会阴伤口处理的首选方法似乎是一期缝合并立即进行负压引流，可伴或不伴冲洗。
