Repair of persistent perineal sinuses by means of a pedicle flap of musculus gracilis. Case report.

Chronic suppurating perineal sinuses are common following proctocolectomy for ulcerative colitis and Crohn's disease. Repeated surgery along conservative lines is often likely to result in failure. If a tissue with normal potentiality for healing is brought to the area of delayed healing, a reasonable chance of success will be achieved. This hypothesis was put forward by Graham (1965) who supported his theory by presenting outstanding results by using a pedicle flap of gracilis in the treatment of rectovaginal fistulas following irradiation. In the present study, Graham's technique was adapted in the treatment of chronic persistent perineal sinuses. The results are promising and the procedure is worth trying in the treatment of longstanding sinuses which fail to heal by conservative methods.