[Drainage following sigmoido-rectal surgery]

There is a great diversity of opinion concerning the management of wounds in rectal surgery. In resection of the rectum we recommend to use the soft Penrose drain, we put in several drains, if the operative field isn't completely clean, we rinse more thoroughly the wound per- and postoperatively in cases of massive bacterial and fecal contamination. Irrigation combined with suction drainage is only installed in presence of general peritonitis. In amputation of the rectum we have abandonned primary closure combined with suction drainage of the perineal wound, a loose bundle drainage neither delaying wound healing nor prolonging hospital stay. In cases of hemorrhage we plug the wound by a Mikulic tampon. If the pelvic floor cannot be closed, we place a plastic sheet on the abdominal side of the Mikulic tampon, this sheet serving as complementary draining system. The disadvantages of every draining system are overruled by their life saving capacities.