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A chronic perineal wound could result due to a variety of causes.

Multiple discharging sinuses should be investigated to rule out Crohn's disease, tuberculosis, or even malignancy. The perineal defects need to be assessed in three dimensions.

The skin defects may be associated with a large dead space in the pelvis following surgical extirpation of tumors. The rigid bony pelvis does not allow the wound to collapse resulting in fluid collection.

It is important to know if the patient has received or is likely to receive radiotherapy. Provision of a well vascularised muscle cover is very important in such a situation. Draining sinuses in a chronic wound need to be probed and may best pussy bullard texas radiological evaluation for assessment of cause and extent of lesion.

An algorithm is suggested to provide guidelines for management in a given Woman wants sex Lexington Nebraska.

It has been suggested that a diversion colostomy helps in better wound management in patients with perineal wounds after trauma or burns. However, a large review of colostomy has highlighted the morbidity associated with this procedure.

These include direct closure of the wound, simple skin graft, or allowing the cavity to heal by secondary intention. However these simple techniques may lead to ificant morbidity in majority of the situations.

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