Archives of Plastic Surgery

  • 제41권4호
  • /
  • Pages.379-386
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  • 2014
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Subunit Principle of Vulvar Reconstruction: Algorithm and Outcomes

  • Tan, Bien-Keem (Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital) ;
  • Kang, Gavin Chun-Wui (Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital) ;
  • Tay, Eng Hseon (Thomson Women Cancer Centre) ;
  • Por, Yong Chen (Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital)
  • 투고 : 2014.06.05
  • 심사 : 2014.07.11
  • 발행 : 2014.07.15
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초록

Background Vulvar defects result chiefly from oncologic resection of vulvar tumors. Reconstruction of vulvar defects restores form and function for the purpose of coitus, micturition, and defecation. Many surgical options exist for vulvar reconstruction. The purpose of this article is to present our experience with vulvar reconstruction. Methods From 2007 to 2013, 43 women presented to us with vulvar defects for reconstruction. Their mean age at the time of reconstruction was 61.1 years. The most common cause of vulvar defect was from resection of vulvar carcinoma and extramammary Paget's disease of the vulva. Method s of reconstruction ranged from primary closure to skin grafting to the use of pedicled flaps. Results The main complications were that of long term hypertrophic and/or unaesthetic scarring of the donor site in 4 patients. Twenty-two patients (51%) were able to resume sexual intercourse. There were no complications of flap loss, wound dehiscence, and urethral stenosis. Conclusions We present a subunit algorithmic approach to vulvar reconstruction based on defect location within the vulva, dimension of the defect, and patient age and comorbidity. The gracilis and gluteal fold flaps are particularly versatile and aesthetically suited for reconstruction of a variety of vulvar defects. From an aesthetic viewpoint the gluteal fold flap was superior because of the well-concealed donor scar. We advocate the routine use of these 2 flaps for vulvar reconstruction.

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참고문헌

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피인용 문헌

  1. Vulvar and vaginal reconstruction using the ''angel wing'' perforator-based island flap vol.137, pp.3, 2015, https://doi.org/10.1016/j.ygyno.2015.03.045
  2. Profunda artery perforator based V‐Y rotation advancement flap for total vulvectomy defect reconstruction—A case report and literature review vol.35, pp.8, 2015, https://doi.org/10.1002/micr.22498
  3. Profunda artery perforator flap for isolated vulvar defect reconstruction after oncological resection vol.113, pp.7, 2016, https://doi.org/10.1002/jso.24233
  4. Reconstruction of Peripelvic Oncologic Defects vol.140, pp.4, 2014, https://doi.org/10.1097/prs.0000000000003703
  5. Vulvo-vaginal reconstruction after radical excision for treatment of vulvar cancer: Evaluation of feasibility and morbidity of different surgical techniques vol.26, pp.4, 2014, https://doi.org/10.1016/j.suronc.2017.10.002
  6. Reconstruction of a large pelvic defect by transfer of a quadruplet combination of pedicled flaps from the medial thigh using bilateral muscular gracilis flaps and bilateral vertical posteromedial thi vol.40, pp.4, 2014, https://doi.org/10.1002/micr.30544
  7. Gender-specific Anatomical Distribution of Internal Pudendal Artery Perforator: A Radiographic Study for Perineal Reconstruction vol.8, pp.10, 2020, https://doi.org/10.1097/gox.0000000000003177
  8. Reconstruction of a radical total vulvectomy defect with a single split anterolateral thigh perforator flap: A case report and review of the literature vol.41, pp.1, 2014, https://doi.org/10.1002/micr.30592