Gracilis Flap Restoring Quality of Life in a Patient with Non Functional Anal Sphincter
Simran Dhole, Firoz Borle, Suhas Jajoo, Chandrashekhar Mahakalkar, Shivani Kshirsagar
1. Junior Resident, Department of Surgery, Jawaharlal Nehru Medical College and Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha, Maharashtra, India.
2. Associate Professor, Department of Surgery, Jawaharlal Nehru Medical College and Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha, Maharashtra, India.
3. Professor, Department of Surgery, Jawaharlal Nehru Medical College and Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha, Maharashtra, India.
4. Professor, Department of Surgery, Jawaharlal Nehru Medical College and Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha, Maharashtra, India.
5. Assistant Professor, Department of Surgery, Jawaharlal Nehru Medical College and Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha, Maharashtra, India.
Correspondence Address :
Dr. Simran Dhole,
Junior Resident, Department of Surgery, Jawaharlal Nehru Medical College and Datta Meghe Institute of Higher Education and Research, Sawangi (Meghe), Wardha-442001, Maharashtra, India.
E-mail: simran1997dhole@gmail.com
Abstract
An excellent technique for reconstructing the perineum following extensive perineal resection for restoration of a traumatised anal sphincter is the Gracilis myocutaneous flap. Direct anal trauma or pelvic injuries can separate the anal sphincters. An overlapping sphincteroplasty has a fair possibility of regaining acceptable fecal continence if roughly half of the sphincter ring is still functional. A case of a 22-year-old male who underwent Gracilis myocutaneous flap reconstruction after being diagnosed with a non functioning anal sphincter is reported. A free muscle transplant was done to repair the sphincter, utilising denervated muscle with an intact blood supply. New muscle was attached to those sphincter muscles which were still functional. The transplanted muscle receives new muscular fibers, enabling the repaired sphincter to contract voluntarily in addition to reflexively. The surgical approach is determined based on the presented sphincter defect. Free muscle transplantation can be preferred in cases where the external sphincter has some degree of functionality.
Keywords
Anal continence, Colorectal repair, Myocutaneous flap, Sigmoidoscopy, Sphincteroplasty, Sphincter defect
DOI and Others
DOI: 10.7860/JCDR/2024/68664.19240
Date of Submission: Nov 19, 2023
Date of Peer Review: Jan 04, 2024
Date of Acceptance: Jan 31, 2024
Date of Publishing: Apr 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Nov 20, 2023
• Manual Googling: Jan 12, 2024
• iThenticate Software: Jan 26, 2024 (6%)
ETYMOLOGY: Author Origin
EMENDATIONS: 6