&NA;A case of anal‐sphincter injury with total fecal incontinence is presented. The use of total parenteral nutrition (TPN) as a “medical colostomy” is stressed. After four weeks of support by TPN, the perineal wound had healed and successful sphincteroplasty was performed. TPN was used in the postoperative period to delay bowel movements for one week. The general concept of the use of TPN in sphincter injury is presented, giving the surgeon an option in management of these injuries without resorting to a preliminary colostomy.