The management of the open perineal wound using a foam elastomer dressing: a prospective clinical trial

In an attempt to improve the management of the perineal wound after abdominoperineal excision of the rectum we have assessed the value of foam elastomer, a catalysed silicone polymer dressing. The substance has already been used successfully in the treatment of open, granulating wounds at other sites (1). On the fourteenth postoperative day 50 patients with open perineal wounds were randomized to receive either conventional gauze packing or treatment with a foam elastomer dressing. Patients were received weekly until healing occurred. When no cavity remained, a dry dressing alone was used. Initial wound volume was calculated in all patients by forming a foam dressing the volume of which was measured by displacement of water. Healing times were shorter in patients who received foam elastomer, but not significantly so. However, less analgesia (P less than 0.01) and fewer district nurse visits (P less than 0.001) were required by patients in the foam elastomer group. This study suggests that foam elastomer dressing is a more comfortable alternative to a gauze pack in the management of the perineal wound and substantially reduces the amount of nursing supervision which is required. We recommend its routine use in the management of the open perineal wound particularly in the young and cooperative patient.