Perineal and vaginal wall reconstruction using a combined inferior gluteal and pudendal artery perforator flap: a case report.
Reliable perineal and posterior vaginal wall restoration following extensive abdominoperineal excision or pelvic exenteration is a reconstructive challenge, especially if the rectus abdominis is unavailable or insufficient for transpelvic transposition. In this short report, we present a novel combined perforator-based technique, in which an inferior gluteal perforator flap is used for perineal reconstruction whereas vaginal reconstruction is performed simultaneously by means of a pudendal artery perforator flap. This procedure circumvents functional muscle loss, permits a tension-free closure of difficult three-dimensional defects and offers a high degree of reconstructive flexibility, which allows a straightforward and independent reconstruction of two different anatomical units.
Department of Plastic and Hand Surgery, Erlangen University Hospital, Krankenhausstr. 12, 91054 Erlangen, Germany. volker.schmidt@uk-erlangen.de
Volker J
VJ
Schmidt
Raymund E
RE
Horch
Adrian
A
Dragu
Klaus
K
Weber
Jonas
J
Göhl
Grit
G
Mehlhorn
Ulrich
U
Kneser
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000601:surgery*; D000328:Adult; D001005:Anus Neoplasms / Q000175:diagnosis / Q000601:surgery*; D002081:Buttocks / Q000098:blood supply; D003424:Crohn Disease / Q000150:complications; D005260:Female; D006801:Humans; D061525:Perforator Flap / Q000098:blood supply*; D010502:Perineum / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D014621:Vagina / Q000601:surgery*