Introduction: Severe perianal sepsis is often difficult to manage after surgical debridement due to faecal contamination. Diversion of the faecal stream has been attempted with faecal pouches and rectal tubes, and in some cases, a diverting stoma is created. However, reversal of the stoma may be delayed due to prolonged sepsis and this is not without risks. Herein, we review the use of a flexible faecal management system in patients with severe perianal sepsis.
Methods: We retrospectively evaluated 15 patients who made use of the ConvaTec Flexi-Seal® Fecal Management System (FMS) between 1 January 2007 and 31 December 2010. The demographics and comorbidities of the patients, as well as the treatment received, were recorded and reviewed.
Results: None of the patients required the creation of a stoma to divert the faecal stream. Nursing requirements and wound care were found to be improved with the use of the Flexi-Seal® FMS (fewer changes were needed). No severe complications were observed in our series. Two deaths were encountered, but the cause of death was not directly due to the initial perianal sepsis. Overall, the wound healing rate was 80.0%, with one graft failure (11.1%).
Conclusion: The use of the Flexi-Seal® FMS in patients with perianal sepsis following extensive debridement is feasible and can be considered before stoma creation.
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| http://dx.doi.org/10.11622/smedj.2014176 | DOI Listing |
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Article Synopsis
- High complex anal fistulas are challenging to treat due to their location above the deep external sphincter, and traditional surgeries often lead to loss of anal function.
- The modified Transanal opening of the intersphincteric space (TROPIS) procedure effectively treats these fistulas while preserving anal sphincter function, minimizing the risks associated with conventional methods.
- A recent case showed successful results with the modified TROPIS, as the patient experienced a full recovery and normal anal function after 17 months, demonstrating its potential as a preferred treatment option.
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