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An Algorithmic Approach to Perineal Reconstruction.

Catherine M Westbom1, Simon G Talbot1

  • 1Division of Plastic Surgery, Brigham and Women's Hospital, Boston, Mass.

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|June 16, 2020
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Summary

Reconstructing challenging perineal wounds requires careful consideration of defect properties. This paper reviews flap coverage options to address complex perineal defects, optimizing functional and aesthetic outcomes.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery

Background:

  • Perineal wounds present significant reconstructive challenges due to their location and potential complications.
  • Factors like radiation, chemotherapy, and contamination complicate perineal defect management.
  • Maintaining critical functions (anal, urethral, vaginal) and patient comfort (sitting) adds to reconstructive complexity.

Purpose of the Study:

  • To discuss the properties of perineal defects that guide the selection of appropriate flap coverage options.
  • To provide a framework for choosing the best reconstructive strategy for complex perineal wounds.

Main Methods:

  • Review of existing literature and clinical experience with perineal reconstruction.
  • Analysis of various flap options based on defect characteristics.

Main Results:

  • Different perineal defect characteristics necessitate specific flap choices for successful reconstruction.
  • Understanding defect properties is key to selecting optimal flap coverage.

Conclusions:

  • The choice of flap for perineal reconstruction is dictated by the specific properties of the defect.
  • A tailored approach considering defect complexity ensures functional and aesthetic restoration.