Background: Fecal diversion is important for healing of perianal wounds. However, traditional fecal diversion with colostomy is associated with risks of general anesthesia and requires healthy abdominal skin for stoma creation. Alternative methods of fecal diversion are needed.
Aim and Objectives: We aimed to illustrate an effective alternate method of fecal diversion in patients with perianal wounds by reporting four patients with perianal wounds who were successfully treated using the Flexi-Seal® fecal management system.
Materials and Methods: The first patient was a 79-year-old female with a grade IV sacral pressure sore who underwent operative debridements and vacuum-assisted wound closure. The second patient was a 21-year-old female with extensive perianal burn wounds who underwent a series of debridements, wound dressing changes, and split-thickness skin grafts. The third and fourth patient were an 84-year-old female and an 85-year-old female receiving negative pressure treatment with no space for vacuum silicone membrane to cover without using the Flexi-Seal® fecal management system. The Flexi-Seal® fecal management system was utilized for fecal diversion in these patients.
Results: Satisfactory wound healing was achieved in each patient using the Flexi-Seal® fecal management system for fecal diversion.
Conclusion: Based on our patients and previous studies that have reported successful treatment of perianal wounds using the Flexi-Seal® fecal management system, this system is feasible to use and effective. We suggest its use in patients with perianal wounds, particularly those in whom colostomy is not preferable or contraindicated.

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