Grafting is associated with high failure rates in the perineal and perianal areas and is not advised for closure of the anal canal either. Grafts in this area may contract, leading to anal stenosis . Some authors argue that cases with extensive tissue resection over the buttocks and perianal region benefit from skin grafting [8, 71], while others find that the overwhelming majority of perineal resections do well with closure by secondary intention . Simple wide excision, early discharge, and home care until healing is complete minimize operative and hospitalization costs and the risk of immobilization. Complete healing requires from 2 to 5 months depending on the extent of initial disease and the surgical intervention. The patients are quite familiar with dressing techniques and therefore require little reinforcement to maintain themselves during the prolonged interval of healing. A better cosmetic result is obtained and many patients are quite concerned about the cosmetic appearance of their buttocks. Large areas will granulate in a period of several months and the patients begin to live a productive life
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