Use of W-plasty in stenotic stoma: a new solution for an old problem.
INDICATION: Amongst late complications of stomas, stenosis can be difficult to treat. Repeated dilatations rarely achieve long-term resolution and re-fashioning is not always successful. Application of an existing plastic surgical technique to treat stomal stenosis is described. METHOD: After marking the skin, a W-plasty is made with a number of consecutive small triangular flaps through the skin. The corresponding mucosal margin is then made to interdigitate with this configuration and fixed using a Gillies corner stich with 5/0 Vycril rapide on a compound curved needle. RESULTS: Five patients underwent W-plasty reconstruction for a stenotic stoma. Median follow up was 12.5 months (range 11-15). No patient had stenosis of the stoma on review and the patient satisfaction rate was high. CONCLUSION: The W-plasty technique is a new treatment for stenotic stoma.