{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T23:52:12Z","timestamp":1746489132871},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2019,8,13]],"date-time":"2019-08-13T00:00:00Z","timestamp":1565654400000},"content-version":"vor","delay-in-days":1320,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Plast Surg"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Background: Although gracilis muscle transposition for faecal incontinence has been well-described method, its literature for use in obstetric perineal tear without colostomy is sparse. In this study, we have tried to analyse its use in fourth-degree obstetric perineal tears. Patients and Methods: A total of 30 patients with recto-vaginal fistula with faecal incontinence secondary to obstetric perineal tear were retrospectively studied between February 2003 and May 2014. The recto-vaginal fistula was explored, dissected and identification of sphincters was done using muscle stimulator. Fistula closure was done followed by sphincter repair, vaginal tightening procedure and single gracilis transposition. None of the patients had covering colostomy. Faecal incontinence was assessed pre- and post-operatively by digital rectal examination (single examiner), Park's score and Corman's score in all cases and using barium hold and transperineal ultrasonography, manometric studies in a few cases. The outcome was measured at an average follow-up of 8.8 months (7\u201324 months). Results: As per Park's score 26 patients had Grade I continence, two had Grade II and two patients had Grade III continence. Corman's score improved from fair to excellent in 26 patients. The patients in whom manometry was performed showed a remarkable rise in both resting and squeeze pressures. Two patients developed post-operative infections in upper 1\/3 thigh incision site and three patients at gluteal region scar site. Conclusion: Satisfactory continence following gracilis muscle could be achieved.<\/jats:p>","DOI":"10.4103\/0970-0358.182236","type":"journal-article","created":{"date-parts":[[2016,5,11]],"date-time":"2016-05-11T01:01:11Z","timestamp":1462928471000},"page":"26-34","source":"Crossref","is-referenced-by-count":4,"title":["Management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years"],"prefix":"10.1055","volume":"49","author":[{"given":"Jiten","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, MGM Medical College, Aurangabad, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuradha J.","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, MGM Medical College, Aurangabad, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhaskar","family":"Musande","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, MGM Medical College, Aurangabad, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek B.","family":"Bhamare","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, MGM Medical College, Aurangabad, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,8,13]]},"reference":[{"key":"key-10.4103\/0970-0358.182236-1","first-page":"853","volume-title":"Construction of a rectal sphincter and restoration of anal continence by transplanting the gracilis muscle; a report of four cases in children","author":"Pickrell","year":"1952","journal-title":"Ann Surg"},{"key":"key-10.4103\/0970-0358.182236-2","first-page":"46","volume-title":"Rectal sphincter reconstruction using gracilis muscle transplant","author":"Pickrell","year":"1954","journal-title":"Plast Reconstr Surg"},{"key":"key-10.4103\/0970-0358.182236-3","first-page":"290","volume-title":"Management of fecal incontinence by gracilis muscle transposition","author":"Corman","year":"1979","journal-title":"Dis Colon Rectum"},{"key":"key-10.4103\/0970-0358.182236-4","first-page":"887","volume-title":"Third degree obstetric anal sphincter tears: Risk factors and outcome of primary repair","author":"Sultan","year":"1994","journal-title":"BMJ"},{"key":"key-10.4103\/0970-0358.182236-5","first-page":"177","volume-title":"Anal incontinence after obstetric third\/fourth-degree laceration.One-year follow-up after pelvic floor exercises","author":"Sander","year":"1999","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"key-10.4103\/0970-0358.182236-6","first-page":"724","volume-title":"Risks of anal incontinence from subsequent vaginal delivery after a complete obstetric anal sphincter tear","author":"Bek","year":"1992","journal-title":"Br J Obstet Gynaecol"},{"key":"key-10.4103\/0970-0358.182236-7","first-page":"392","volume-title":"Sphincter rupture in childbirth","author":"S\u00f8rensen","year":"1993","journal-title":"Br J Surg"},{"key":"key-10.4103\/0970-0358.182236-8","first-page":"1905","volume-title":"Anal-sphincter disruption during vaginal delivery","author":"Sultan","year":"1993","journal-title":"N Engl J Med"},{"key":"key-10.4103\/0970-0358.182236-9","first-page":"950","volume-title":"A prospective study of anal sphincter injury due to childbirth","author":"Rieger","year":"1998","journal-title":"Scand J Gastroenterol"},{"key":"key-10.4103\/0970-0358.182236-10","first-page":"312","volume-title":"Obstetric anal sphincter injury ten years after: Subjective and objective long term effects","author":"Fornell","year":"2005","journal-title":"BJOG"},{"key":"key-10.4103\/0970-0358.182236-11","first-page":"552","volume-title":"Follow-up evaluation of gracilis muscle transposition for fecal incontinence","author":"Corman","year":"1980","journal-title":"Dis Colon Rectum"},{"key":"key-10.4103\/0970-0358.182236-12","first-page":"86","volume-title":"Anal incontinence following obstetrical injury","author":"Corman","year":"1985","journal-title":"Dis Colon Rectum"},{"key":"key-10.4103\/0970-0358.182236-13","first-page":"S21","volume-title":"Gracilis muscle transposition for anal incontinence: Late results","author":"Corman","year":"1985","journal-title":"Br J Surg"},{"key":"key-10.4103\/0970-0358.182236-14","doi-asserted-by":"crossref","unstructured":"LeguitP Jr., van Baal JG, Brummelkamp WH. Gracilis muscle transposition in the treatment of fecal incontinence. Long-term follow-up and evaluation of anal pressure recordings. Dis Colon ssswRectum 1985;28:1-4.","DOI":"10.1007\/BF02553893"},{"key":"key-10.4103\/0970-0358.182236-15","doi-asserted-by":"crossref","unstructured":"Baeten CG, Bailey HR, Bakka A, Belliveau P, Berg E. Safety and efficacy of dynamic graciloplasty for fecal incontinence: report of a prospective, multicenter trial. Dynamic Graciloplasty Therapy Study Group. 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