Combination Therapy of Vacuum Sealing Drainage and Counter-Current Irrigation for Refractory Perianal Wounds

Perianal refractory wounds refer to long-term non-healing wounds of the skin and soft tissues surrounding the anus, often resulting from surgery or complications of chronic diseases. Current treatment mainly focuses on maintaining an open wound environment and allowing healing to follow its natural course. Due to the specific anatomical location, susceptibility to secondary infection, and the local wound environment, healing often requires more than 4 weeks. Vacuum-sealed drainage (VSD), combined with counter-current irrigation technology, has been widely adopted and demonstrated significant efficacy in specialties such as burn and plastic surgery, orthopedics, and general surgery. This non-invasive negative-pressure technology offers new approaches for treating refractory perianal wounds, promoting active intervention in the healing process, accelerating healing speed, improving healing quality, and reducing patient discomfort. This article describes the management and application details of this technology for refractory perianal wounds, including methods of outer-film application at different positions, differences in negative-pressure settings based on wound distance from the anal margin, and strategies to avoid secondary contamination. This methodology may facilitate broader clinical adoption of VSD for perianal refractory wounds and presents new therapeutic opportunities for managing such challenging non-healing wounds.