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Dermal flap coverage (anal advancement flap) there are a number of surgical options to cure anal fissures , including dermal flap coverage (also known as an anal advancement flap) in which adjacent skin (dermal flap) can be moved into the anus to cover the fissure. anal fistula house dermal advancement flap was fashhioned in the anterior quadrant of the anal canal. I am thinking unlisted 46999 ? Has any one had one of these before or any thoughts. Dermal flap has a good success rate for healing anal fistulas, with most healing rates reported to be in the 7080 range (table 15. In fact, the healing rate may be even greater than this, as many of the studies demonstrating lower success rates had small numbers of patients.). Purpose internal sphincterotomy is considered the standard for treating anal fissure, but it is associated with a risk of impaired anal continence. This study aimed to conduct a long-term follow-up to compare postoperative anal continence using dermal flap coverage or lateral internal sphincterotomy for treatment of chronic anal fissure. treatment of anal fistula can be difficult for both the patient and the surgeon, as fistulas can be difficult to eliminate even under the best of circumstances. One procedure which surgeons who treat fistulas should be familiar with is the dermal advancement flap. Has anyone had dermal flap surgery for an anal fissure - especially anyone who has a j pouch - can you describe recovery - thank this topic is answered by a medical expert. George theodoropoulos, md, facs, fascrs associate professor of surgery athens medical school lateral internal sphincterotomy (lis) is considered the surgical. Download citation cutaneous advancement flap combined with tailored lateral internal sphincterotomy for chronic anal fissure results from our prospective database and review of the literature. simple cutaneous advancement flap anoplasty should be considered as a first-line surgical treatment of chronic anal fissure, irrespective of patient gender and anal tone. Lateral anal sphincteroto sphincter-sparing anoplasty has been advocated as an alternative procedure for those with low pressure sphincters. Symptoms of mild anal incontinence (ie, soiling, flatus) were present 3 months after operation in 6 of 30 (20. 0) patients with lateral internal sphincterotomy and in no patient with dermal flap coverage (p . 05) 70 to 94 months postoperatively, mild anal incontinence was present in 10 of 21 (47. 6) patients with lateral internal sphincterotomy and in 1 of 17 (5.).