title: Postablative reconstruction of vulvar defects with local fasciocutaneous flaps and superficial fascial system repair.
abstract: BACKGROUND
  Postablative reconstruction of vulvar defects is a difficult challenge because of the functional, locational and cosmetic importance of this region. Local flaps carry a high incidence of delayed wound healing as local flaps may redistribute but not eliminate local wound tension. Repair of the superficial fascial system may avert local complications by minimising tension to the skin and increasing the initial biomechanical strength of wound. The aim of this study was to determine the clinical outcome of local fasciocutaneous flaps used for postablative reconstruction of vulvar defects in which the superficial fascial system was repaired.
  
  
  METHODS
  A retrospective analysis was conducted of patients with vulvar carcinoma in situ or vulvar carcinoma, who underwent ablation and immediate reconstruction with local fasciocutaneous flaps and superficial fascial system repair. Postoperative complications were recorded and clinical outcomes were evaluated.
  
  
  RESULTS
  Twelve of the 13 flaps healed primarily. Complications included 2 superficial wound infections, both of which were treated successfully with antibiotic therapy. One flap was complicated by minor wound dehiscence, which healed with conservative treatment.
  
  
  CONCLUSIONS
  Local fasciocutaneous flaps with superficial fascial system repair provide excellent design flexibility and can be designed and tailored to reconstruct postablative vulvar defects with good outcomes and minimal morbidity.
authors.affiliation: Department of Plastic Surgery, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, North Rhine-Westphalia, Germany. sammyalbenna@doctors.org.uk
authors.forename: Sammy
authors.initials: S
authors.lastname: Al-Benna
authors.forename: Elias
authors.initials: E
authors.lastname: Tzakas
mesh_terms: D055011:Ablation Techniques / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002278:Carcinoma in Situ / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000382:microbiology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D040521:Subcutaneous Tissue / Q000601:surgery; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000188:drug therapy; D016896:Treatment Outcome; D014844:Vulva / Q000601:surgery*; D014846:Vulvar Neoplasms / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents