{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:32:48Z","timestamp":1740166368398,"version":"3.37.3"},"reference-count":8,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Fournier's gangrene is a life-threatening infection which requires prompt recognition, early surgical debridement of unhealthy tissue, and initiation of broad-spectrum antibiotics. Relook debridement are usually performed until all the devitalized tissue has been removed. Involvement of the anal sphincter may result in significant morbidity such as permanent incontinence. Dynamic reconstruction of the anal sphincter has always been one of the holy grails in the field of pelvic reconstruction.<\/jats:p><jats:p>We demonstrate a new method of camera shutter style double-opposing gracilis muscle flaps that allows dynamic sphincteric function without the need for electrostimulation. The bilateral gracilis muscles are inset in a fashion that allows orthograde contraction of the muscle to narrow and collapse the neoanal opening. With biofeedback training, the patient is able to regain dynamic continence and return to function without a stoma. There was also no need for neurotization or microsurgery techniques to restore sphincteric function to the anus. The patient was able to reverse his stoma 14 months after the initial insult and reconstruction with biofeedback training without the use of electrostimulation.<\/jats:p>","DOI":"10.1055\/s-0043-1772755","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T05:00:28Z","timestamp":1696568428000},"page":"496-500","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic Reconstruction of Anal Sphincter with Camera Shutter Style Double-Opposing Gracilis Flaps"],"prefix":"10.1055","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7924-5155","authenticated-orcid":false,"given":"Allen Wei-Jiat","family":"Wong","sequence":"additional","affiliation":[{"name":"Plastic, Reconstructive and Aesthetic Surgery Service, Department of General Surgery, Sengkang General Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5095-2734","authenticated-orcid":false,"given":"Grace Hui-Min","family":"Tan","sequence":"additional","affiliation":[{"name":"Plastic, Reconstructive and Aesthetic Surgery Service, Department of General Surgery, Sengkang General Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3717-4480","authenticated-orcid":false,"given":"Frederick Hong-Xiang","family":"Koh","sequence":"additional","affiliation":[{"name":"Colorectal Service, Department of General Surgery, Sengkang General Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min Hoe","family":"Chew","sequence":"additional","affiliation":[{"name":"Colorectal Service, Department of General Surgery, Sengkang General Hospital, Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"issue":"10","key":"ref1","first-page":"e18948","article-title":"Fournier's gangrene diagnosis and treatment: a systematic review","volume":"13","author":"G D Lewis","year":"2021","journal-title":"Cureus"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"942437","DOI":"10.5402\/2012\/942437","article-title":"Fournier's gangrene: current practices","volume":"2012","author":"M N Mallikarjuna","year":"2012","journal-title":"ISRN Surg"},{"issue":"09","key":"ref3","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1007\/s00268-005-0777-3","article-title":"Fournier's gangrene: risk factors and strategies for management","volume":"30","author":"H Yanar","year":"2006","journal-title":"World J Surg"},{"issue":"08","key":"ref4","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1007\/BF02237392","article-title":"Anorectal reconstruction after abdominoperineal resection. Experience with double-wrap graciloplasty supported by low-frequency electrostimulation","volume":"41","author":"E Cavina","year":"1998","journal-title":"Dis Colon Rectum"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1093\/gastro\/gou014","article-title":"Adynamic and dynamic muscle transposition techniques for anal incontinence","volume":"2","author":"G Bari\u0161i\u0107","year":"2014","journal-title":"Gastroenterol Rep (Oxf)"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"272","DOI":"10.5999\/aps.2019.01032","article-title":"Anorectal malformation with didelphys uterus: extremely rare anomaly and successful neoanal sphincter reconstruction with gracilis muscle flap","volume":"47","author":"C Burusapat","year":"2020","journal-title":"Arch Plast Surg"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1097\/SAP.0000000000001770","article-title":"Graciloplasty for anal incontinence-is electrical stimulation necessary?","volume":"82","author":"A J Gohil","year":"2019","journal-title":"Ann Plast Surg"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/BF02234165","article-title":"Anal sphincter reconstruction by dynamic graciloplasty after abdominoperineal resection for cancer","volume":"42","author":"P Rouanet","year":"1999","journal-title":"Dis Colon Rectum"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0043-1772755.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T06:30:42Z","timestamp":1696573842000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0043-1772755"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":8,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2023,10,5]]},"published-print":{"date-parts":[[2023,9]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0043-1772755","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"type":"print","value":"2234-6163"},{"type":"electronic","value":"2234-6171"}],"subject":[],"published":{"date-parts":[[2023,9]]}}}