Anal Wound and Sphincter Repair from under Its Floor by Buried Stitches

Objective: Blunt and penetrating injuries to the anus and rectum are uncommon. Considerable debate remains regarding the optimal treatment of anorectal injuries. This report offers a technique for repair of anorectal wound from under its floor.

Design: The anorectal wound was repaired by multiple double incomplete circular stitches under its floor.

Setting: This study was conducted in the General Surgery Department, Zagazig University Hospital, Egypt.

Patients: This study was undertaken on 20 patients (15 male and 5 female with mean age of 40.7 years) with anorectal wounds from April 2012 to May 2014.

Interventions: Under general or spinal anesthesia, primary repair of anorectal wounds by special stitches passed under the wound floor not crossing the wound edges, without fecal diversion and presacral drainage.

Results: In 12 patients, the technique was done under general anesthesia and the remainder under spinal anesthesia. The anorectal wounds were healed within 8 weeks. Early complications included superficial wound infection in 15 patients, urine retention in 9 patients, and transient incontinence in 18 patients for period ranged from 4 to 6 weeks. No permanent incontinence, no deep infection, no abscess or fistular formation, no keyhole deformity, and no mortality were recorded.

Conclusion: Our technique for primary repair of anal wound and sphincter is simple, effective, and no need for fecal diversion or presacral drainage.