Analysis of the use of fasciocutaneous flaps for immediate vulvar reconstruction

To analyze the use of immediate reconstruction techniques of the vulva after surgical resection, with fasciocutaneous flaps of the medial and/or posterior thigh.

We conducted a transversal, retrospective study to analyse the outcome of immediate surgical reconstruction with fasciocutaneous flaps in nine patients who underwent vulvectomy from May 2009 to August 2010.

Mean age was 61 years (range 36-82). In 56% of cases, diagnosis was vulvar intraepithelial neoplasia (VIN), usual type. Radical vulvectomy was performed in 45% of patients, simple vulvectomy in 33% and wide resections in 22%. Eleven fasciocutaneous flaps were made, of which 36.3% were flap transpositions from the posterior thigh, 18.2% from the medial thigh, 18.2% were in advancement flaps, 18.2% simple advancement flaps and 9.1% flap rotation from the posterior thigh. There were no major losses of the flaps made.

Thigh fasciocutaneous flaps are currently the best options for immediate reconstruction after resection of vulvar cancer due to the preservation of sensibility and tissue availability in the donor areas. The association of the Plastic Surgeon with the Gynecologist offers tranquility for patients and provides good postoperative results.