Page C P, Carlton P K, Becker D W
Dis Colon Rectum. 1980 Jan-Feb;23(1):2-9. doi: 10.1007/BF02587192.
Between January 1975 and July 1977, 26 patients, who underwent combined synchronous removal of the rectum and anus, were managed within guidelines aimed at achieving primary closure and healing of their operative wounds. The guidelines include preoperative mechanical and luminal antibiotic bowel preparation, perioperative systemic chemoprophylaxis, a combined synchronous ablative procedure in Lloyd-Davies position, short-term sump drainage of the presacral space, meticulous hemostatis, and primary closure of both the pelvic defect above (utilizing an omental pedicle graft to obliterate the pelvic dead space) and the perineal defect below (by primary suture or with gracilis myocutaneous flap). All wounds healed totally within the first six weeks postoperatively, with a mean time to healing of 3.5 weeks in the six patients whose wounds failed to heal primarily. There were no instances of late wound breakdown and follow-up from six months to two years.
1975年1月至1977年7月期间，26例接受直肠和肛门联合同步切除的患者按照旨在实现手术伤口一期闭合和愈合的指导方针进行治疗。这些指导方针包括术前机械性和肠腔内抗生素肠道准备、围手术期全身化学预防、在劳埃德 - 戴维斯体位进行联合同步切除手术、骶前间隙短期引流、细致止血，以及对上方盆腔缺损（利用带蒂网膜移植填充盆腔死腔）和下方会阴缺损（通过一期缝合或股薄肌肌皮瓣）进行一期闭合。所有伤口均在术后六周内完全愈合，六例伤口未能一期愈合的患者平均愈合时间为3.5周。未出现晚期伤口裂开情况，随访时间为六个月至两年。
