Modified gluteal-fold flap for the reconstruction of vulvovaginal defects.
BACKGROUND
Reconstruction of vulvovaginal defects after tumor excision requires good-quality skin cover because of the cosmetic and functional importance of this region. Although numerous techniques for vulvovaginal reconstruction have been described, an ideal approach has yet to be widely accepted.


METHODS
Seven gluteal-fold flaps advanced in a V-Y fashion were used to cover vulvovaginal defects in five patients who underwent surgical treatment for extramammary Paget's disease or carcinoma of the vulva.


RESULTS
Each flap survived completely with no complication other than partial dehiscence in one case and temporary postoperative discomfort and pain upon sitting. None of the patients suffered from recurrence of the tumor.


CONCLUSIONS
In our experience, this flap is easily elevated, not bulky, and reliable because it is supplied by the internal pudendal artery and vein perforators without excessive skeletonization of the vascular pedicle, and it has matched local skin quality. In addition, it has minimal donor-site morbidity as the scar is concealed in the gluteal fold. It can cover medium-sized vulvovaginal defects after tumor excision.
Nakamura
Yasuhiro
Y
Department of Dermatology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan. ynakamurta3@yahoo.co.jp
Ishitsuka
Yosuke
Y
Nakamura
Yoshiyuki
Y
Xu
Xuezhu
X
Hori-Yamada
Enmi
E
Ito
Michiko
M
Onizawa
Saori
S
Kawachi
Yasuhiro
Y
Otsuka
Fujio
F
D000368:Aged; D005260:Female; D006801:Humans; D010145:Paget Disease, Extramammary / Q000601:surgery*; D013524:Surgical Flaps; D014625:Vaginal Neoplasms / Q000601:surgery*; D014846:Vulvar Neoplasms / Q000601:surgery*