Cosmetic aspect of proctological surgeries

Abstract

Although it may seem that the aesthetic appearance of a wound after proctological surgery is of secondary importance relative to the cure of disease, it may affect proper healing, treatment efficacy and the maintenance of anal function. Cosmetic correction of the anal region primarily includes removal of marginal anodermal folds and correction of deformities after proctological surgeries. We present indications for the removal of hypertrophied anodermal folds, as well as situations when such surgery should be abandoned. The most common deformities after proctological surgeries include keyhole deformity, which forms after anal fissure surgery with posterior sphincterotomy and surgical treatment of anal fistula with Hippocrates’ drainage, as well as deformities due to abnormal wound healing. In addition to poor cosmetic result, deformities may lead to functional complications in the form of anal leakage, underwear staining and poor gas continence, which requires surgical correction. Another group includes patients with anal deformity due to scars after multiple proctological procedures, but with no functional defects. The management in these patients largely depends on their mental attitude to these defects and usually no surgical treatment is implemented. Good cosmetic result after proctological surgery often corresponds with good functional outcome and patient’s postoperative satisfaction.