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Perineal Reconstruction with the Perineal Perforator Based Island Flap  

Lee, Hae Min (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University)
Kim, Jeong Tae (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University)
Hwang, Weon Joong (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University)
Publication Information
Archives of Plastic Surgery / v.32, no.1, 2005 , pp. 105-109 More about this Journal
Abstract
Perineal area is composed of compact structures of urogenital organs and anus requiring a more sophisticated selection of flap and reconstruction. For achieving better outcome then conventional flap surgery, we use the perineal perforator based island flap for its reconstruction. After locating the perforator by Doppler, the flaps were designed according to the defect or expected vaginal orifice. The flaps were elevated bilaterally as island pattern. Finally defect or neovagina was reconstructed with inconspicious linear scar hidden in the inguinal crease. Five cases were performed with the perineal perforator based island flap. There were 3 cases of vulvar cancer, 1 case of transsexualism, and 1 case of ambiguous genitalia because of congenital adrenal hyperplasia. Operative results were satisfactory with good contouring and less prominent donor scar, when they were compared with other flap reconstructions such as latissimus dorsi perforator flap, groin flap, gracilis myocutaneous flap etc. The perineal perforator based island flap is highly recommended with the advantages of easy flap elevation, good rotation arc, and appropriate flap thickness for contouring. Compared with other conventional flaps, it can be selected as a good option for moderate defect of perineal area.
Keywords
Perforator based island flap; Perineal reconsruction;
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Times Cited By KSCI : 1  (Citation Analysis)
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1 Lee PK, Choi MS, Oh DY, Lee JW, Ahn ST: Vulvoperieneal Reconstruction Using Various Fasciocutaneous Flaps J Korean Soc Plast Reconstr Surg 31: 479, 2004
2 Oosterlinck W, Monstrey S: The pudendal thigh fasciocutaneous flap to cover deep perineal defects, combined with reconstruction of the posterior urethra. BJU Int 89: 133, 2002   DOI   ScienceOn
3 Gurlek A, Evans GR: The Malaga flap for vaginoplasty in the Mayer-Rokitansky-Kuster-Hauser syndrome: experience and early-term results. Plast Reconstr Surg 100: 806, 1997   DOI
4 Knol AC, Hage JJ: The infragluteal skin flap: a new option for reconstruction in the perineogenital area. Plast Reconstr Surg 99: 1954, 1997   DOI   ScienceOn
5 Shigenobu S,Shugo S,Hideo H: A Subcutaneous Pedicle Flap for Perineal Reconstruction Ann Plas Surg 22: 440, 1989   DOI   ScienceOn
6 Giraldo F: Cutaneous Neovaginoplasty using the Malaga flap (Vulvoperineal Fasciocutaneous flap): a 12-year follow-up. Plast Reconstr Surg 111: 1249, 2003   DOI   ScienceOn
7 Gurlek A, Monstrey S, Prof S: The versatility of the pudendal thigh fasciocutaneous flap used as an island flap. Plast Reconstr Surg 109: 402, 2002   DOI   ScienceOn
8 Goldwyn RM: History of attempts form a vagina. Plast Reconstr Surg 59: 319, 1977   DOI   ScienceOn
9 McCraw JB, Massey FM, Shanklin KD, Horton CE: Vaginal reconstruction with gracilis myocutaneous flaps. Plast Reconstr Surg 58: 176, 1976   DOI   ScienceOn
10 Park CS, Moon JH, Lee NH, Yang KM: Gluteal Fold Fasciocutaneous Turnover Flap for Reconstruction of Perineum and Vaginal Wall J Korean Soc Plast Reconstr Surg 29: 475, 2002
11 Wee JT, Joseph VT: A new technique of vaginal reconstruction using neurovascular pudendal-thigh flaps: a preliminary report. Plast Reconstr Surg 4: 701, 1989
12 Giraldo F, Mora MJ, Solano A, Abehsera M, Ferron M, Smith JM: Anatomic study of the superficial perineal neurovascular pedicle: implications in vulvoperineal flap design. Plast Reconstr Surg 1: 100, 1997