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Perineal perforator switch flap for three-dimensional vulvovaginal reconstruction
Jongweon Shin1, Seong Ae Kim2, Jong-Won Rhie2
1Department of Plastic and Reconstructive Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Tongil-ro 1021, Eunpyeong-gu, Seoul, Republic of Korea.
Summary
The perineal perforator switch flap (PPSF) offers a simpler, faster vulvovaginal reconstruction with improved aesthetic outcomes and quicker recovery compared to previous methods. This technique shows promise for enhancing patient recovery and satisfaction in reconstructive surgery.
Area of Science:
- Reconstructive Surgery
- Plastic Surgery
- Gynecologic Oncology
Background:
- Vulvovaginal reconstruction presents significant surgical challenges.
- Evaluating novel flap techniques is crucial for improving patient outcomes.
- Comparison with established methods is essential for validating new approaches.
Purpose of the Study:
- To assess the efficacy and outcomes of the perineal perforator switch flap (PPSF) for vulvovaginal reconstruction.
- To compare the long-term esthetic results of PPSF with the previously used perineal perforator propeller flap (PPPF).
Main Methods:
- Retrospective review of 16 patients (27 flaps) undergoing vulvovaginal reconstruction with PPSF.
- Flap design centered on identified perineal perforators, transferred via subcutaneous tunnel.
- Preservation of surrounding soft tissue and pedicle integrity during elevation.
Main Results:
- All 27 PPSF flaps survived without major complications.
- Shorter operation times (79.38 min) and faster recovery (walking at 1.69 days, hospitalization 5.69 days).
- PPSF demonstrated superior esthetic results in symmetry and labial shape compared to PPPF (p<0.05).
Conclusions:
- PPSF is a technically simple and efficient method for vulvovaginal reconstruction.
- The technique reduces operative time and recovery duration, facilitating timely adjuvant therapy.
- PPSF offers improved esthetic outcomes and is a promising option for vulvovaginal reconstruction.
