Arch Hand Microsurg.  2018 Mar;23(1):63-67. 10.12790/ahm.2018.23.1.63.

Bilateral Vulvar Reconstruction Using Two Different Types of Perforator Flap: A Case Report

• Ki SH
• Sim SH
• Lee SH

• KMID: 2412493
• DOI: http://doi.org/10.12790/ahm.2018.23.1.63

Abstract

We reconstructed an extensive vulvar defect with the internal pudendal artery and the anterior obturator artery perforator flap and compared the two types of flaps. A 57-year-old female patient had a 15×13 cm2 defect on both sides around the vagina after vulvectomy. Due to the injury in the internal pudendal artery, we used the internal pudendal artery perforator on the right side, and the anterior obturator artery perforator flap on the left side. The internal pudendal artery perforator flap could be rotated easily 120 degrees toward the vulvar defect. However, as the anterior obturator artery perforator flap was difficult to rotate, reconstruction was performed by rotation and advancement. The anterior obturator artery perforator flap is a viable alternative method that can be used when it is difficult to use the internal pudendal artery perforator flap during vulvar reconstruction.

Keyword

Vulvar neoplasms; Perforator flap; Rotation

MeSH Terms

Arteries
Female
Humans
Methods
Middle Aged
Perforator Flap*
Vagina
Vulvar Neoplasms

Figure

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  Fig. 1 Both sides of the vulvar defect; preparation of the medial thigh V-Y advancement flap.

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  Fig. 2 (A) Internal pudendal artery perforator flap, right side (rotation state). (B) Anterior obturator artery perforator flap, left side (before advancement, rotation).

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  Fig. 3 Immediate post-surgery.

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  Fig. 4 Five months post-surgery. After debulking of the flap and multiple Z-plasty.

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