J Korean Soc Plast Reconstr Surg.  2005 Jan;32(1):105-109.

Perineal Reconstruction with the Perineal Perforator Based Island Flap

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea. jtkim@hanyang.ac.kr

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.

Keyword

Perforator based Island flap; Perineal reconsruction

MeSH Terms

Adrenal Hyperplasia, Congenital
Anal Canal
Cicatrix
Disorders of Sex Development
Groin
Humans
Myocutaneous Flap
Perforator Flap
Superficial Back Muscles
Tissue Donors
Transsexualism
Vulvar Neoplasms
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