Dynamic rectus abdominis muscle flap for intestinal stomal continence: A systematic approach
✍ Scribed by Wayne K. Stadelmann; Janou W.J.M. Bardoel; Gustavo Perez-Abadia; Ramsey K. Majzoub; Claudio Maldonado; Gordon R. Tobin; Moshe Kon; John H. Barker
- Publisher
- John Wiley and Sons
- Year
- 2001
- Tongue
- English
- Weight
- 292 KB
- Volume
- 21
- Category
- Article
- ISSN
- 0738-1085
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✦ Synopsis
Abstract
Several attempts to create a continent stomal sphincter using dynamic myoplasty with limited success have been reported. Denervation atrophy and early muscle fatigue have plagued all reported attempts to make a continent stoma a reality. To address this problem in a series of experiments, we designed a stomal sphincter using the most caudal segment of the rectus abdominis muscle. Then, we performed a study to determine whether a sphincter created with a rectus abdominis muscle island flap could maintain stomal continence in the short term. We found that when stimulated using two different electrical stimulation protocols, in all cases the rectus abdominis muscle sphincter generated peak pressures well above those needed to maintain stomal continence (60 mm Hg). All sphincters were able to maintain stomal continence at all intraluminal bowel pressures tested. We found one of these protocols to be far superior and reached 4 hours of stomal continence after 8 to 10 weeks of electrical stimulation. © 2001 Wiley‐Liss, Inc. MICROSURGERY 21:248–255 2001