Vulvoperineal reconstruction with a sulcus gluteus flap.
OBJECTIVE
To describe vulvoperineal reconstruction with a flap of the sulcus gluteus.


METHODS
Nonrandomized, prospective study in patients with vulvar cancer and vulvar intraepithelial neoplasia. After oncologic surgery, reconstruction with a sulcus gluteus flap was performed. The flap is supplied by the internal pudendal artery, and innervation is provided by the pudendal nerve. The tuber ischiale is the anatomic landmark for locating the pedicle. Follow-up was from 2 months to 2 years. Immediate and long-term complications were assessed. Aesthetic and functional results were analyzed and related to the quality of life and length of hospitalization.


RESULTS
Vulvoperineal reconstruction was carried out in 6 patients who had undergone radical surgery. For reconstruction we used the sulcus gluteus flap in 4 unilateral cases and in 2 bilateral cases, for a total of 8 flaps. Cutaneous flaps of the sulcus gluteus provided good functional and aesthetic results. All flaps survived. There was no flap necrosis. The average length of hospitalization was 4 days. Complications were 2 breakdowns of the wound and 1 lymphocele. Postoperative discomfort was minimum. Patients were allowed to walk on day 6 and to sit on day 15.


CONCLUSIONS
The advantages of this reconstruction are that it: is useful in cases of lymphadenectomy, is sensitive and maintains innervation, is distant enough from the receptor area to be used for large vulvar lesions, is able to hide the scar from the donor area in the sulcus gluteus, has a low complication rate, has a short hospitalization time and provides very good compliance with follow-up.
Bistoletti
Pedro
P
Buenos Aires University, José de San Martin Hospital, Buenos Aires, Argentina.
Cravino
Teresita
T
Belardi
M Graciela
MG
D000328:Adult; D000368:Aged; D002081:Buttocks; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008875:Middle Aged; D010502:Perineum / Q000601:surgery; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D012494:Sampling Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000473:pathology / Q000601:surgery*