Anal S-plasty for "Whitehead deformity"

Anal stenosis and mucosal ectropion

Anal stenosis (AS) or stricture is defined as the loss of compliant natural elasticity of the anal opening, which then becomes abnormally tight and fibrous. It is a very disabling condition, worsened by the patient's embarrassment, but uncommon. The vast majority of cases are secondary to trauma, iatrogeny, inflammatory diseases, or neoplasia, or occur postradiation. Depending on the severity and level of involvement, AS can be classified as mild, moderate, or severe. Due to the rarity of this pathology and the different referral patterns among institutions, the etiology ranges widely between published reports. There are multiple surgical techniques that have been described for the correction or improvement of AS. Moderate or severe AS is the usual indication for operative treatment.

S-plasty for various anal lesions

Ten patients underwent S-plasty between July 1979 and April 1990 for the treatment of various anal conditions. Six patients had giant condyloma acuminata, and there was one patient each with Bowen's disease, verrucous carcinoma, and stricture, and ectropion (Whitehead deformity). Both anatomic and functional results were satisfactory in all patients, and there were no serious complications. S-plasty is the preferred method for the reconstruction of extensive circular denuded anal canal with full-thickness graft of bilateral rotating skin flaps. It is important not only to construct large flaps with a good blood supply, but also to obtain complete hemostasis of the raw surface.