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Perineal Reconstruction with a Diamond-shaped Perforator Flap: A Case Report
Parthena I Deskoulidi1, Pantelis K Diamantopoulos1, Nikolaos A Maltzaris1
1Department of Plastic Surgery, St. Savvas Cancer Hospital of Athens, Athens, Greece; Department of Plastic Surgery, Evangelismos General Hospital of Athens, Athens, Greece; and Department of Plastic Surgery, 401 General Military Hospital of Athens, Athens, Greece.
Abstract:
Reconstruction of perineal defects is a challenging procedure. Various surgical techniques have been proposed. Compared with traditional myocutaneous flaps, pedicled perforator flaps are believed to be a less invasive option for perineal reconstruction, with better functional and cosmetic results. We present the case of a 47-year-old woman with a perianal Paget's disease who underwent surgical excision of the lesion. The reconstructive technique was a pedicled flap based on an internal pudendal skin perforator artery. The flap was designed in a diamond-shaped pattern. Six months after the operation, the patient is disease-free with successful aesthetic and functional results. A polygonal diamond-shaped flap is an easy and reliable choice for perineal reconstruction, offering better adjustment in the perianal region and avoidance of the curvilinear perianal incision (which often leads to anal stenosis).
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