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.
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Robertson HD, Ray JE, Ferrari BT, Gathright JB Jr. Management of rectal trauma. Surg Gynecol Obstet 1982;154:161–4.
Tuggle D, Huber PJ Jr. Management of rectal trauma. Am J Surg 1984;148:806–8.
Goligher JC. Surgery of the anus, rectum, and colon. 4th ed. London: Bailliere Tindall, 1980:915.
Goligher JC, King DP, Simmons HT. Injuries produced by blast in water. Lancet 1943;2:119–23.
Sohn N, Weinstein MA, Gonchar J. Social injuries of the rectum. Am J Surg 1977;134:611–3.
Mortensen NJ, Irvin TT. Disembowelment per rectum: a fatal rectal injury. Br J Surg 1984;71:289.
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.
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.
Pickrell KL, Georgiade N, Maguire C, Crawford H. Gracilis muscle transplant for rectal incontinence. Surgery 1956;40:349–63.
Pickrell KL, Masters FW, Georgiade N, Horton C. Rectal sphincter reconstruction using gracilis muscle transplant. Plast Reconstr Surg 1954;13:46–55.
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.
Luzzani S, et al. Gracilis muscle transplant in anal incontinence. Riv Ital Chir Plast 1977;9:493.
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.
McGregor RA. Gracilis muscle transplant in anal incontinence. Dis Colon Rectum 1965;8:141–3.
Birnbaum W. Fecal incontinence. In: Turell R. Diseases of the colon and anorectum. 2nd ed. Philadelphia: WB Saunders, 1969;2:1029–43.
Orticochea M. A new method of total reconstruction of the penis. Br J Plast Surg 1972;25:347–66.
McCraw JB, Massey FM, Shanklin KD, Horton CE. Vaginal reconstruction with gracilis myocutaneous flaps. Plast Reconstr Surg 1976;58:176–83.
Orticochea M. The musculo-cutaneous flap method: immediate and heroic substitute for the method of delay. Br J Plast Surg 1972;25:106–10.
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.
Osborne R. The treatment of pressure sores in paraplegic patients. Br J Plast Surg 1955;8:214–23.
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.
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.
Minami RT Mills R, Pardoe R. Gluteus maximus myocutaneous flaps for repair of pressure sores. Plast Reconstr Surg 1977;60:242–9.
Mathes SJ, Nahai F. Clinical atlas of muscle and musculocutaneous flaps. 1st ed. St. Louis: CV Mosby, 1979:68.
Todd IP, Fielding LP, eds. Rob and Smith's surgery of the alimentary tract and abdominal wall. 4th ed. Boston: Butterworths, 1985;3:385.
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Govila, A. Reconstruction of partial rectal and sacral loss by gracilis and gluteus maximus muscle island transfer. Dis Colon Rectum 31, 470–473 (1988). https://doi.org/10.1007/BF02552620
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DOI: https://doi.org/10.1007/BF02552620