Format

Send to

Choose Destination
See comment in PubMed Commons below
Gynecol Oncol. 2013 Dec;131(3):726-9. doi: 10.1016/j.ygyno.2013.08.030. Epub 2013 Sep 1.

Vulvar reconstruction using the "lotus petal" fascio-cutaneous flap.

Author information

1
Division of Gynecologic Oncology, University of Minnesota, Minneapolis, USA. Electronic address: argenta@umn.edu.

Abstract

INTRODUCTION:

Vulvar reconstruction using the "lotus petal" fascio-cutaneous flap offers a relatively novel means to restore symmetry and functionality after extirpative gynecologic or oncologic procedures. We sought to assess the success rates and morbidity in a large series of consecutively treated patients.

METHODS:

We performed a retrospective review of 59 consecutive cases of lotus petal flaps performed at a single institution to more accurately assess success and complication rates.

RESULTS:

We identified 80 flaps performed among the 59 patients between September 1, 2008 and March 30, 2013. The median (range) age was 59 years (24-89) and the median (range) BMI was 27 kg/m(2) (19-34). The indications for vulvar/perineal excision were as follows: 39 (66.1%) vulvar carcinoma or melanoma, 12 (20.3%) vulvar dysplasia, 5 (8.5%) colorectal disease and 3 (5.1%) cases of hidradenitis suppurativa. The mean defect area, determined by post-fixation pathology specimen was 29 cm(2). Medical or surgical complications occurred in 36% of patients of which superficial wound separation was the most common (15%). There were no cases of complete flap loss, but partial loss occurred in 7 (8.8%) cases. 3 (5.1%) patients required re-operation prior to discharge with one case requiring skin grafting. Delayed surgical revision was required in 4 patients for partial flap loss (2) or stricture/stenosis (2).

CONCLUSION:

The lotus petal flap is safe for use in gynecologic reconstruction, with acceptable short- and long-term complication rates. Previous reports of smaller series likely underestimate the risk of complications through case selection.

KEYWORDS:

Flap; Lotus petal; Vulva; Vulvar reconstruction; Vulvar surgery

PMID:
24004648
DOI:
10.1016/j.ygyno.2013.08.030
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center