Advertisement

Diseases of the Colon & Rectum

, Volume 31, Issue 6, pp 470–473 | Cite as

Reconstruction of partial rectal and sacral loss by gracilis and gluteus maximus muscle island transfer

Report of a case
  • Ashok Govila
Article

Abstract

This study presents a rare case of extensive tissue loss from the posterior pelvic wall (gluteal, sacral, and perianal region) and from the intrapelvic organs (rectum) following unusual trauma. This patient underwent successful reconstruction by a method that has not been previously described. Rectal wall reconstruction was performed using gracilis muscle transfer, and sacral reconstruction was performed by gluteus maximus muscle island transfer. Three-year follow-up demonstrated a normal life pattern.

Key words

Rectal and sacral reconstruction Gracilis transfer Gluteus maximus island transfer 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Robertson HD, Ray JE, Ferrari BT, Gathright JB Jr. Management of rectal trauma. Surg Gynecol Obstet 1982;154:161–4.PubMedGoogle Scholar
  2. 2.
    Tuggle D, Huber PJ Jr. Management of rectal trauma. Am J Surg 1984;148:806–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Goligher JC. Surgery of the anus, rectum, and colon. 4th ed. London: Bailliere Tindall, 1980:915.Google Scholar
  4. 4.
    Goligher JC, King DP, Simmons HT. Injuries produced by blast in water. Lancet 1943;2:119–23.CrossRefGoogle Scholar
  5. 5.
    Sohn N, Weinstein MA, Gonchar J. Social injuries of the rectum. Am J Surg 1977;134:611–3.PubMedCrossRefGoogle Scholar
  6. 6.
    Mortensen NJ, Irvin TT. Disembowelment per rectum: a fatal rectal injury. Br J Surg 1984;71:289.PubMedGoogle Scholar
  7. 7.
    Pickrell KL, Broadbent TR, Masters FW, Metzger JT. Construction of a rectal sphincter and restoration of anal continence by transplanting the gracilis muscle: a report of four cases in children. Ann Surg 1952;135:853–62.PubMedCrossRefGoogle Scholar
  8. 8.
    Pickrell KL, Georgiade N, Maguire C, Crawford H. Correction of rectal incontinence: transplantation of the gracilis muscle to construct a rectal sphincter. Am J Surg 1955;90:721–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Pickrell KL, Georgiade N, Maguire C, Crawford H. Gracilis muscle transplant for rectal incontinence. Surgery 1956;40:349–63.PubMedGoogle Scholar
  10. 10.
    Pickrell KL, Masters FW, Georgiade N, Horton C. Rectal sphincter reconstruction using gracilis muscle transplant. Plast Reconstr Surg 1954;13:46–55.PubMedCrossRefGoogle Scholar
  11. 11.
    Pickrell KL, Georgiade N, Richard EF, Morris F. Gracilis muscle transplant for the correction of neurogenic rectal incontinence. Surg Clin North Am 1959;39:1405–15.PubMedGoogle Scholar
  12. 12.
    Luzzani S, et al. Gracilis muscle transplant in anal incontinence. Riv Ital Chir Plast 1977;9:493.Google Scholar
  13. 13.
    Nieves PM, Valles TG, Arangúren G, Maldonado D. Gracilis muscle transplant for correction of traumatic anal incontinence: report of a case. Dis Colon Rectum 1975;18:349–54.PubMedGoogle Scholar
  14. 14.
    McGregor RA. Gracilis muscle transplant in anal incontinence. Dis Colon Rectum 1965;8:141–3.PubMedGoogle Scholar
  15. 15.
    Birnbaum W. Fecal incontinence. In: Turell R. Diseases of the colon and anorectum. 2nd ed. Philadelphia: WB Saunders, 1969;2:1029–43.Google Scholar
  16. 16.
    Orticochea M. A new method of total reconstruction of the penis. Br J Plast Surg 1972;25:347–66.PubMedCrossRefGoogle Scholar
  17. 17.
    McCraw JB, Massey FM, Shanklin KD, Horton CE. Vaginal reconstruction with gracilis myocutaneous flaps. Plast Reconstr Surg 1976;58:176–83.PubMedCrossRefGoogle Scholar
  18. 18.
    Orticochea M. The musculo-cutaneous flap method: immediate and heroic substitute for the method of delay. Br J Plast Surg 1972;25:106–10.PubMedCrossRefGoogle Scholar
  19. 19.
    Converse JM. Reconstructive plastic surgery: principles and procedures in correction, reconstruction and transplantation: the lower extremity, the trunk, the genitourinary tract. 2nd ed. Philadelphia: WB Saunders, 1977;7:3562.Google Scholar
  20. 20.
    Osborne R. The treatment of pressure sores in paraplegic patients. Br J Plast Surg 1955;8:214–23.PubMedCrossRefGoogle Scholar
  21. 21.
    Hurwitz DJ, Schwartz WM, Mathes SJ. The gluteal thigh flap: a reliable, sensate flap for the closure of buttock and perineal wounds. Plast Reconstr Surg 1981;68:521–30.PubMedCrossRefGoogle Scholar
  22. 22.
    Stallings JO, Delgado JP, Converse JM. Turnover island flap of gluteus maximus muscle for the repair of sacral decubitus ulcer. Plast Reconstr Surg 1974;54:52–4.PubMedCrossRefGoogle Scholar
  23. 23.
    Minami RT Mills R, Pardoe R. Gluteus maximus myocutaneous flaps for repair of pressure sores. Plast Reconstr Surg 1977;60:242–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Mathes SJ, Nahai F. Clinical atlas of muscle and musculocutaneous flaps. 1st ed. St. Louis: CV Mosby, 1979:68.Google Scholar
  25. 25.
    Todd IP, Fielding LP, eds. Rob and Smith's surgery of the alimentary tract and abdominal wall. 4th ed. Boston: Butterworths, 1985;3:385.Google Scholar

Copyright information

© American Society of Colon and Rectal Surgeons 1988

Authors and Affiliations

  • Ashok Govila
    • 1
  1. 1.Department of Plastic and Reconstructive SurgeryPostgraduate Institute of Medical Education and ResearchChandigarhIndia

Personalised recommendations