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Perineal reconstruction using single gracilis myocutaneous flaps

T W Burke1, M Morris, M S Roh

  • 1Department of Gynecologic Oncology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.

Gynecologic Oncology
|May 1, 1995
PubMed
Summary

Single gracilis flaps offer a versatile solution for reconstructing large perineal defects after extensive cancer surgery. This method effectively restores form and function in vulvovaginal reconstructions, improving patient outcomes.

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Area of Science:

  • Plastic Surgery
  • Surgical Oncology
  • Gynecologic Oncology

Background:

  • Gracilis myocutaneous flaps were initially used for neovagina creation after pelvic exenteration.
  • Experience with bilateral flaps led to the use of single flaps for perineal defect repair.

Purpose of the Study:

  • To evaluate the efficacy of single gracilis myocutaneous flaps in vulvovaginal reconstruction.
  • To assess outcomes in patients with large perineal defects following oncologic resections.

Main Methods:

  • Eighteen single gracilis flaps were used for reconstruction in 17 women over 5 years.
  • Reconstructions addressed defects from anorectal or vulvovaginal tumors, including recurrent or advanced disease.
  • Flaps were placed externally for vulva/perineum or internally for vaginal replacement.

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Main Results:

  • Mean flap size was 6.6 x 11.4 cm; mean operative time was 377 minutes with 1010 cc blood loss.
  • Complications included flap skin necrosis (3 patients) and minor wound separations (5 patients).
  • Hospital stay averaged 18.4 days; 8 patients were alive and disease-free at a median 25-month follow-up.

Conclusions:

  • The single gracilis flap is a versatile option for anatomic reconstruction of extensive perineal defects.
  • It provides a reliable tissue source for patients requiring vulvovaginal reconstruction after cancer surgery.