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J Surg Oncol. 2016 Jun;113(7):828-34. doi: 10.1002/jso.24233. Epub 2016 Apr 7.

Profunda artery perforator flap for isolated vulvar defect reconstruction after oncological resection.

Chang TN1,2, Lee CH1,2, Lai CH2,3, Wu CW1,2,4, Chang CS2,5, Cheng MH1,2,4, Huang JJ1,2,4.

Author information

1
Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
2
Chang Gung University, College of Medicine, Taoyuan, Taiwan.
3
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
4
Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
5
Division of Craniofacial Surgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Abstract

Isolated vulvar reconstruction using profunda artery-based perforator flaps have good functional as well as quality of life restoration. Surgical techniques, complications, and final evaluation using questionnaires are presented.

BACKGROUND:

Vulvar reconstruction remains a great challenge to reconstructive surgeons. A local fasciocutaneous flap from the medial thigh is a good option with multiple choices of the donor arteries. Here, we extended the clinical application of a profunda perforator artery (PAP) flap with the design of an island pedicle flap.

METHODS:

From 2012 to 2015, 12 female patients with vulvar cancer received tumor ablation and immediate reconstruction using a PAP flap. The flaps (n = 19) were divided into V-Y advancement perforator flap (group I, n = 4) and island pedicle perforator flap (group II, n = 15). All of the demographic data were collected and analyzed.

RESULTS:

All of the flaps were transferred successfully, and all of the donor sites were closed without morbidities. Group II was superior to group I because of the smaller required flap size (P = 0.004), the smaller defect size/flap size ratio (P = 0.001), and a lower rate of post-op debridement (P = 0.037). The other parameters were not statistically significant.

CONCLUSIONS:

PAP flap is a good choice for vulvar reconstruction. We preferred an island pedicle setting for its thin and pliable fasciocutaneous component and robust flap circulation. The favorable functional and aesthetic results can be achieved with limited donor site morbidities. J. Surg. Oncol. 2016;113:828-834. © 2016 Wiley Periodicals, Inc.

KEYWORDS:

PAP flap; deep femoral artery; pedicle perforator flap; profunda artery; vulvar reconstruction

PMID:
27062060
DOI:
10.1002/jso.24233
[Indexed for MEDLINE]

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