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Updated: Jul 18, 2026
Engineered Vascularized Muscle Flap
Published on: January 11, 2016
Use of the genito-crural island perforator flap in vulvar reconstruction: a single-center experience
Victoire Commenge1, Alejandra Martinez2, Giulio Ricotta2
1Institut Universitaire du Cancer Toulouse Oncopole, Department of Plastic and Reconstructive Surgery, Toulouse, France.
Objective:
Vulvar cancer represents 5% of all gynecological malignancies, but its incidence has increased. Management of early stages requires radical local excision, with simultaneous reconstruction when direct suturing is not indicated. The genito-crural island perforator flap is a reliable option that can be considered in most vulvar reconstruction cases, combining limited morbidity and preservation of aesthetic and functional vulvar concerns.
Methods:
This monocentric, retrospective single-arm study includes patients treated between 2021 and 2025, who underwent vulvar cancer surgical resection with genito-crural island perforator flap reconstruction. The study aims to highlight the feasibility and surgical results of this flap in terms of wound healing, hospitalization duration, and post-operative outcomes.
Results:
Of the 27 patients included, 19 had bilateral genito-crural island perforator flap reconstruction, resulting in a total of 46 flaps. A total of 59.3% of patients had no risk factors for impaired healing, despite an occasionally advanced age (median 61 years, range; 35-81) and patients often being overweight (median 27.7kg/m2, range; 18.7-43.6) and smokers (44.4%). A complete vulvar healing was obtained in less than 4 weeks in 78.3% and in more than 8 weeks in 4.3%. Adjuvant vulvar radiotherapy was administered with no delay in treatment initiation. Donor sites healed in less than 4 weeks in 69.6% and in more than 8 weeks in 2.2%. The median hospitalization duration was 4 days (range; 1-15). Post-operative complications occurred in 33.3% of patients, primarily, wound dehiscence (17.4%) or local infection (21.7%). No cases of total flap necrosis were observed. No life-threatening complications related to vulvar reconstruction were observed.
Conclusions:
Genito-crural island perforator flap is a simple and reliable procedure, enabling rapid healing with short post-operative recovery, low morbidity, and satisfactory functional and morphological outcome. In our practice as a tertiary cancer center, we routinely use this flap.
