Innervated island flaps in morphofunctional vulvar reconstruction

Area of Science:

• Reconstructive Surgery
• Plastic Surgery
• Gynecologic Oncology

Background:

• Vulvectomy, a procedure to remove vulvar tissue, often necessitates vulvar reconstruction.
• Innervated island flaps offer a viable solution for restoring form and function after vulvectomy.

Purpose of the Study:

• To present the authors' experience with two distinct innervated island flap techniques for vulvar reconstruction.
• To evaluate the efficacy and outcomes of these reconstructive methods based on defect characteristics.

Main Methods:

• Description of two surgical techniques: V-Y amplified sliding flap from the pubis and fasciocutaneous island flap from gluteal folds.
• Application of flaps based on defect size, location (anterior vs. posterior), and symmetry.
• Surgical procedures performed on 22 patients between 1989 and the present.

Main Results:

• 14 patients underwent V-Y amplified sliding flap reconstruction; 7 used gluteal fold island flaps.
• Both techniques demonstrated compatibility with inguino-femoral lymphadenectomy.
• Successful morphofunctional reconstruction with good local sensibility and aesthetically satisfactory results achieved.

Conclusions:

• The V-Y amplified sliding flap and gluteal fold island flap are effective for vulvar reconstruction post-vulvectomy.
• These methods provide good functional and aesthetic outcomes, with scars concealed in natural folds.
• The choice of flap depends on the specific defect, ensuring optimal reconstructive results.