Repair of old complete perineal lacerations

Our subjects were 32 patients whose old complete perineal lacerations were repaired in the 10 hospitals in the South Hampton Roads Metropolitan area over a 20-year period. The layer technique of repair (26 patients) and the Warren flap procedure (6 patients) were used. Function improved in 24 of 26 patients (92%) with adequate follow-up. Function was completely restored in 22 of 26 patients (85%). The use of a careful mechanical and antimicrobial bowel prep is emphasized, as is the debatable use of the paradoxical incision (Miller).