Reconstruction of the perineum

Defects of the perineal area commonly occur following ablative procedures for gynecological, urological, and colorectal malignancies. A coordinated approach between the surgical oncologist and the reconstructive surgeon is necessary in order to achieve appropriate results in these patients. Consideration of both form and function is essential and must be planned for. A variety of reconstructive procedures, including skin grafts, local skin flaps, various myocutaneous and fasciocutaneous flaps and, in rare situations, free tissue transfers, are used in the closure of these wounds. An algorithm for the selection of these various procedures is presented so that uncomplicated wound healing can be achieved and functional results can be optimized. Semin. Surg. Oncol. 19:282-293, 2000.