Vulvoperineal Reconstruction Using Various Fasciocutaneous Flaps.

Lee, Paik Kwon; Choi, Moon Seop; Oh, Deuk Young; Rhie, Jong Won; Ahn, Sang Tae

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2004;31(4):479-484.
Published online July 1, 2004.

Vulvoperineal Reconstruction Using Various Fasciocutaneous Flaps.

Paik Kwon Lee, Moon Seop Choi, Deuk Young Oh, Jong Won Rhie, Sang Tae Ahn

Department of Plastic Surgery The Catholic University of Korea College of Medicine, Seoul, Korea. stahn@catholic.ac.kr

Abstract

The reconstruction after radical vulvectomy presents a difficult challenge. Ideal flap for vulvoperineal reconstruction has thin character, constant vascular supply, and presents concealed scar after reconstruction. Various flaps are used for reconstruction of the vulvar area, have their own advantages and disadvantages. The authors performed 15 vulvoperineal reconstructions using three kinds of different 28 fasciocutaneous flaps. Gluteal fold fasciocutaneous island flap seems like labia major and remains concealed donor scar along the gluteal fold. But secondary debulking procedure is sometimes required. Vulvoperineal V-Y advancement fasciocutaneous flap is thin, reliable, easily elevated, and matches with regional skin quality, but donor site scar is conspicuous on medial thigh. Gluteal fold V-Y advancement fasciocutaneous flap is also reliable, easily elevated, and matches with regional skin quality with thin flap and concealed donor scar on gluteal fold. Also, it can be advanced even a long distance. Through our experiences, these flaps are very useful for vulvar reconstruction, but in the aspect of donor site scar, thickness, and degree of advancement, gluteal fold V-Y advancement fasciocutaneous flap is superior to the other two patterns for the reconstruction of the large sized vulvoperineal defect.

Keywords: Vulvar reconstruction; Fasciocutaneous flap; V-Y advancement; Gluteal fold