Vulvovaginal reconstruction following radical surgery

Area of Science:

• Reconstructive surgery
• Gynecological oncology
• Plastic surgery

Background:

• Complete rehabilitation is crucial for women with gynecological malignancies, alongside improved survival.
• Reconstructive techniques can correct therapy-induced effects after radical surgery or later.
• Choosing the least morbid, most reliable procedure minimizes complications and aids recovery.

Purpose of the Study:

• To review available reconstructive techniques for gynecological malignancies.
• To emphasize the importance of selecting appropriate procedures for optimal patient outcomes.
• To guide the choice of reconstructive methods based on defect characteristics and patient factors.

Main Methods:

• Review of various reconstructive surgical techniques including split-thickness skin grafts (STSG), full-thickness skin flaps, fasciocutaneous flaps, and myocutaneous flaps.
• Discussion of indications and contraindications for each technique.
• Consideration of factors influencing procedural choice, such as defect size, tissue loss, and blood supply requirements.

Main Results:

• Split-thickness skin grafts (STSG) are suitable for superficial defects and vaginal reconstruction.
• Full-thickness skin flaps address significant skin and subcutaneous tissue loss in the vulva, groin, or vagina.
• Myocutaneous flaps offer reliable blood supply for complex reconstructions, with options for size modification and secondary STSG.

Conclusions:

• No single reconstructive procedure is ideal for all situations; familiarity with multiple techniques is essential.
• Successful reconstruction depends on careful patient selection, procedural knowledge, and precise surgical technique.
• The goal is to balance anatomy and function through appropriate, sometimes combined, reconstructive approaches.