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Subunit Principle of Vulvar Reconstruction: Algorithm and Outcomes
Tan, Bien-Keem,Kang, Gavin Chun-Wui,Tay, Eng Hseon,Por, Yong Chen Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.4
Background Vulvar defects result chiefly from oncologic resection of vulvar tumors. Reconstruction of vulvar defects restores form and function for the purpose of coitus, micturition, and defecation. Many surgical options exist for vulvar reconstruction. The purpose of this article is to present our experience with vulvar reconstruction. Methods From 2007 to 2013, 43 women presented to us with vulvar defects for reconstruction. Their mean age at the time of reconstruction was 61.1 years. The most common cause of vulvar defect was from resection of vulvar carcinoma and extramammary Paget's disease of the vulva. Method s of reconstruction ranged from primary closure to skin grafting to the use of pedicled flaps. Results The main complications were that of long term hypertrophic and/or unaesthetic scarring of the donor site in 4 patients. Twenty-two patients (51%) were able to resume sexual intercourse. There were no complications of flap loss, wound dehiscence, and urethral stenosis. Conclusions We present a subunit algorithmic approach to vulvar reconstruction based on defect location within the vulva, dimension of the defect, and patient age and comorbidity. The gracilis and gluteal fold flaps are particularly versatile and aesthetically suited for reconstruction of a variety of vulvar defects. From an aesthetic viewpoint the gluteal fold flap was superior because of the well-concealed donor scar. We advocate the routine use of these 2 flaps for vulvar reconstruction.
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Subunit Principle of Vulvar Reconstruction: Algorithm and Outcomes
Bien-Keem Tan,Gavin Chun-Wui Kang,Eng Hseon Tay,Yong Chen Por 대한성형외과학회 2014 Archives of Plastic Surgery Vol.41 No.4
Background: Vulvar defects result chiefly from oncologic resection of vulvar tumors. Reconstructionof vulvar defects restores form and function for the purpose of coitus, micturition,and defecation. Many surgical options exist for vulvar reconstruction. The purpose of thisarticle is to present our experience with vulvar reconstruction. Methods: From 2007 to 2013, 43 women presented to us with vulvar defects for reconstruction. Their mean age at the time of reconstruction was 61.1 years. The most commoncause of vulvar defect was from resection of vulvar carcinoma and extramammary Paget’sdisease of the vulva. Method s of reconstruction ranged from primary closure to skin graftingto the use of pedicled flaps. Results: The main complications were that of long term hypertrophic and/or unaestheticscarring of the donor site in 4 patients. Twenty-two patients (51%) were able to resume sexualintercourse. There were no complications of flap loss, wound dehiscence, and urethral stenosis. Conclusions: We present a subunit algorithmic approach to vulvar reconstruction based ondefect location within the vulva, dimension of the defect, and patient age and comorbidity. The gracilis and gluteal fold flaps are particularly versatile and aesthetically suited for reconstructionof a variety of vulvar defects. From an aesthetic viewpoint the gluteal fold flap wassuperior because of the well-concealed donor scar. We advocate the routine use of these 2flaps for vulvar reconstruction.
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