USE OF AN ABDOMINAL FLAP GRAFT IN CONSTRUCTION OF A PERMANENT ILEOSTOMY

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Abstract
THE PATIENT who must have a permanent ileostomy has been materially benefited by the technic of Dragstedt and his associates,1 who covered the terminal ileum with a split thickness of skin, thus providing a greater length of bowel externally and facilitating the collection of fecal material into a suitable container. The inherent tendency, however, of both the bowel and a split thickness graft to contract may, over a period of time, result in a marked shortening of the ileostomy. In 1 patient for whom we made such an ileostomy, the original 3½ inches (9 cm.) of skincovered ileum over a period of eighteen months contracted to the point that only ¼ inch (0.6 cm.) of skin remained and the mucosal edges of the bowel were in contact with the skin of the abdomen. This occurred in spite of a primary take of the graft. There would undoubtedly be less

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