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The perineal wound which closes and heals after proctectomy does so because the pelvic cavity is obliterated, mainly by downward descent of the peritoneal floor and to some extent by posterior movement of the urogenital structures bounding this space anteriorly. This process, in many instances, can be aided and hastened by primary closure with suction drainage. Acute and chronic sepsis within this cavity produces a thick-walled, rigid tract which precludes obliteration of the space with the resultant development of a chronic sinus. Under this circumstance, only adequate drainage, sometimes requiring excision of the coccyx and sacrum will suffice to marsupialize the wound and thus allow healing.
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- New YorkMay, 1973 Presentation at annual meeting of Society for Surgery of the Alimentary Tract,
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Accepted: January 8, 1974
© 1974 Published by Elsevier Inc.