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Traumatic Cloacal Defect, the Warren Flap Revisited a Description of the Technique and Review of the Literature

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Narula H., Wadhawan H., Shorthouse A., Brown S.

Polish Journal of Surgery

2010

vol. 82

issue 12

687-693

Traumatic cloacal defects are rare and are characterised by complete dehiscence of the anterior sphincter complex, the perineal body and lower portion of the rectovaginal septum. Techniques of repair range from simple tissue apposition to complex flap reconstruction. We report a series of patients treated by a ‘Warren flap’.Methods. A review of four patients undergoing Warren flap repair for traumatic cloacal defect.Results. The Warren flap was performed with minimal complications. Patients were discharged within 2 days. Minor wound infections occurred in all four cases. At median follow up of 7.5 months (range 3-10 months) all patients had significantly improved continence (Vaisey score median 16 pre-op to 3 post-op) and sexual function.Conclusions. The Warren flap procedure utilises techniques and planes that are familiar to the colorectal surgeon, and is associated with rapid and safe recovery and good early postoperative function. It is a useful reconstructive technique for this complex injury.

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1 Polish Journal of Surgery

1 2010

1 Brown S.

1 Narula H.

1 Shorthouse A.

1 Wadhawan H.

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Traumatic Cloacal Defect, the Warren Flap Revisited a Description of the Technique and Review of the Literature