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Triple flap technique for vulvar reconstruction.

R Mercut1, R Sinna1, R Vaucher1

  • 1Department of plastic reconstructive and aesthetic surgery, university hospital of Picardie, 80054 Picardie cedex 1, France.

Annales De Chirurgie Plastique Et Esthetique
|April 14, 2018
PubMed
Summary
This summary is machine-generated.

This study introduces a novel 3-flap technique for reconstructing extensive perineal skin defects after vulvar cancer surgery. The method offers a simple, reliable solution with minimal donor site morbidity, improving patient management.

Keywords:
Cancer vulvaireLambeaux d’avancement en V-YPerforante pudendalePudendal perforatorReconstructionV-Y advancement flapsVulvar cancer

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Area of Science:

  • Surgical Oncology
  • Reconstructive Surgery
  • Plastic Surgery

Background:

  • Perineal defects frequently arise from vulvar cancer treatment and abdominoperineal resection.
  • Surgical excision of vulvar cancer often results in significant skin defects requiring reconstruction.
  • Current reconstruction aims to resurface the perineum rather than add volume.

Purpose of the Study:

  • To present a new surgical technique for covering extensive perineal skin defects.
  • To evaluate the efficacy of a 3-flap advancement technique in vulvar cancer reconstruction.

Main Methods:

  • The study involved 3 patients undergoing large excisions for vulvar cancer with lymph node dissection.
  • Reconstruction utilized three advancement flaps: two V-Y flaps based on pudendal perforator arteries and one Y-V Mons pubis flap.
  • Flaps were designed to cover postero-lateral and superior aspects of the perineal defect.

Main Results:

  • The 3-flap technique successfully covered the perineal defects in all patients.
  • One patient experienced non-union, which healed by secondary intention.
  • Negative pressure wound therapy on sutures yielded excellent results in the other two cases.

Conclusions:

  • The 3-flap technique is a simple, reliable method for perineal reconstruction.
  • This technique offers minimal donor site morbidity and can be performed without repositioning the patient.
  • It avoids the need for delicate perforator dissection, simplifying surgical management.