Free microneurovascular gracilis muscle transfer in the dog for enterostomal sphincter construction and control: an...

Hundreds of thousands of individuals struggle today with the morbidity of an abdominal wall enterostoma. This study explored two ways of constructing abdominal wall sphincter mechanisms in dogs using gracilis muscles transferred by free microneurovascular technique. Transferred muscles successfully generated pressures greater than the normal external anal sphincter but could not maintain this level of contraction for tonic sphincter closure. Other transferred muscles were designed to straighten the course of stomas continent at rest. They provided strong linear pull uncoiling the stomas but simultaneously pinched off the orifices during contraction. This opening model shows promise if the muscle attachments around the stoma orifices could be made less constricting.