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• W2160771237 abstract "Some life-saving surgeries result in the necessity to establish permanent intestinal stomas; this outcome has an undeniable physical and emotional effect on the patient's life. Although patients with permanent stomas reasonably adjust, complications that include peristomal skin irritation, pouching system dysfunction, social inhibition, depression, and sexual dysfunction also have been reported. The quest for intestinal stomal continence has resulted in numerous non-surgical and surgical continent diversion techniques. The use of dynamic myoplasty is one of them. Dynamic myoplasty is a term given to the use of electrical stimulation devices to stimulate surgically elevated muscle flaps. It has been used to treat fecal and urinary incontinence using a gracilis muscle flap neo-sphincter. Another clinical example is use of the lattissimus dorsi muscle to augment the pump function of the heart in patients with chronic heart failure. None of the attempted techniques to maintain stomal continence have enjoyed widespread use because of associated complications or because these techniques were not able to provide complete continence. However, the use of dynamic myoplasty to achieve stomal continence has also met with limited success. Denervation atrophy caused by flap elevation to construct the sphincter and early muscle fatigue caused by continuous electrical stimulation were responsible for these disappointing results. It was our goal to see if we could make an abdominal stoma continent using dynamic myoplasty. A multiphase project was undertaken that was designed to solve the critical issues of denervation atrophy and early muscle fatigue. To solve the problem of denervation atrophy an anatomic feasibility study was undertaken in fresh human cadavers. This first study was designed to determine which local muscle could serve as an innervated and well-perfused muscle flap. The rectus abdominis muscle (RAM) was found to be ideal. Of the two RAM stoma sphincter designs the island flap was found to be superior to the peninsula flap design. The next phase of the study was to identify an animal suitable for the development of a model for stoma sphincter design. In an acute canine study, it was determined that the RAM island flap sphincter design used in human cadavers could be applied to the dog. Using an electrical stimulation device, the muscle was able to be stimulated and to generate peak pressures well above 60 mm Hg (pressure needed to maintain fecal continence in humans). Muscle fatigue was found to be directly proportional to the stimulation frequency and continence was provided at all the tested bowel pressures (30, 65 and 100 mm Hg). These promising acute functional study results paved the way for the initiation of chronic trials incorporating survival operations in dogs. In the first chronic study, it was revealed that the sphincter design was fatigue-resistant for 4 hours up to three months post-op with one of the two training protocols tested. In addition, a second chronic study was undertaken to test whether direct nerve stimulation, as opposed to intramuscular stimulation, would render more favorable results. Although the numbers were too small there was a tendency that the sphincter could be trained faster with direct nerve stimulation. However, electrode failure (displacement and lead fracture) led to a non-functioning sphincter in 63% of the cases when using direct nerve stimulation." @default.
• W2160771237 created "2016-06-24" @default.
• W2160771237 creator A5023999642 @default.
• W2160771237 date "2002-04-23" @default.
• W2160771237 modified "2023-09-24" @default.
• W2160771237 title "Dynamic Rectus Abdominis Muscle Sphincter for Stomal Continence" @default.
• W2160771237 cites W117538475 @default.
• W2160771237 cites W1512666316 @default.
• W2160771237 cites W1559546823 @default.
• W2160771237 cites W1562017869 @default.
• W2160771237 cites W1569437831 @default.
• W2160771237 cites W1607271942 @default.
• W2160771237 cites W169056113 @default.
• W2160771237 cites W1863103714 @default.
• W2160771237 cites W1964276415 @default.
• W2160771237 cites W1965214745 @default.
• W2160771237 cites W1966102354 @default.
• W2160771237 cites W1966305047 @default.
• W2160771237 cites W1967281762 @default.
• W2160771237 cites W1969209427 @default.
• W2160771237 cites W1970969079 @default.
• W2160771237 cites W1971405119 @default.
• W2160771237 cites W1975226855 @default.
• W2160771237 cites W1979622630 @default.
• W2160771237 cites W1980901607 @default.
• W2160771237 cites W1981500412 @default.
• W2160771237 cites W1981575394 @default.
• W2160771237 cites W1981784044 @default.
• W2160771237 cites W1984049778 @default.
• W2160771237 cites W1985714070 @default.
• W2160771237 cites W1988376390 @default.
• W2160771237 cites W1991079642 @default.
• W2160771237 cites W1991175764 @default.
• W2160771237 cites W1993380472 @default.
• W2160771237 cites W1994255568 @default.
• W2160771237 cites W1997065182 @default.
• W2160771237 cites W1999029388 @default.
• W2160771237 cites W2000485577 @default.
• W2160771237 cites W2001837137 @default.
• W2160771237 cites W2005934930 @default.
• W2160771237 cites W2006807587 @default.
• W2160771237 cites W2007076860 @default.
• W2160771237 cites W2007242433 @default.
• W2160771237 cites W2011740556 @default.
• W2160771237 cites W2013625538 @default.
• W2160771237 cites W2014276001 @default.
• W2160771237 cites W2015868879 @default.
• W2160771237 cites W2017391755 @default.
• W2160771237 cites W2020109189 @default.
• W2160771237 cites W2020970504 @default.
• W2160771237 cites W2021690789 @default.
• W2160771237 cites W2022020973 @default.
• W2160771237 cites W2022653137 @default.
• W2160771237 cites W2023780655 @default.
• W2160771237 cites W2024607984 @default.
• W2160771237 cites W2025817274 @default.
• W2160771237 cites W2025852602 @default.
• W2160771237 cites W2027681974 @default.
• W2160771237 cites W2027950802 @default.
• W2160771237 cites W2028350472 @default.
• W2160771237 cites W2029220199 @default.
• W2160771237 cites W2029444385 @default.
• W2160771237 cites W2029621364 @default.
• W2160771237 cites W2030189480 @default.
• W2160771237 cites W2030931337 @default.
• W2160771237 cites W2032890567 @default.
• W2160771237 cites W2033760417 @default.
• W2160771237 cites W2034706106 @default.
• W2160771237 cites W2036163498 @default.
• W2160771237 cites W2036663522 @default.
• W2160771237 cites W2037595611 @default.
• W2160771237 cites W2038188196 @default.
• W2160771237 cites W2038188822 @default.
• W2160771237 cites W2041264305 @default.
• W2160771237 cites W2042483253 @default.
• W2160771237 cites W2044486786 @default.
• W2160771237 cites W2045441736 @default.
• W2160771237 cites W2045615534 @default.
• W2160771237 cites W2048388773 @default.
• W2160771237 cites W2048883406 @default.
• W2160771237 cites W2049087952 @default.
• W2160771237 cites W2050266872 @default.
• W2160771237 cites W2051886251 @default.
• W2160771237 cites W2053222865 @default.
• W2160771237 cites W2053929648 @default.
• W2160771237 cites W2057287386 @default.
• W2160771237 cites W2057433308 @default.
• W2160771237 cites W2062848446 @default.
• W2160771237 cites W2063010992 @default.
• W2160771237 cites W2063791516 @default.
• W2160771237 cites W2064523577 @default.
• W2160771237 cites W2065455664 @default.
• W2160771237 cites W2066704600 @default.
• W2160771237 cites W2067401965 @default.
• W2160771237 cites W2067777358 @default.
• W2160771237 cites W2068594260 @default.
• W2160771237 cites W2068753566 @default.
• W2160771237 cites W2069456464 @default.
• W2160771237 cites W2071459124 @default.
• W2160771237 cites W2071676878 @default.

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