title: Reconstruction of the vulva with sensate gluteal fold flaps.
abstract: OBJECTIVE
  Soft-tissue reconstruction of the vulva following resection of malignancies is challenging. The function of perineal organs should be preserved and the reconstructed area should maintain an acceptable cosmetic appearance. Reconstruction with local flaps is usually sufficient in the primary phase after a radical vulvectomy. Numerous flaps have been designed for vulvar reconstruction usually based on circulation from the internal pudendal artery branches. In this paper we introduce our modification of the gluteal fold V-Y advancement flap as a primary reconstruction after a radical vulvectomy.
  
  
  METHODS
  Twenty-two patients were operated with a radical vulvectomy because of vulvar malignancies. The operation was primary in eight and secondary in 14 patients. The reconstruction of the vulva was performed in the same operation for each patient.
  
  
  RESULTS
  All flaps survived completely. Wound complications were registered in three patients. Late problems with urinary stream were corrected in two patients. A local recurrence of the malignancy was observed in six patients during the follow-up period.
  
  
  CONCLUSIONS
  Gluteal fold flap is easy to perform, has a low rate of complications and gives good functional results. Even a large defect can be reconstructed reliably with this method. A gluteal fold V-Y advancement flap is sensate and our modification allows the flap to be transposed with lesser dissection as presented before.
authors.affiliation: Department of Plastic Surgery, Tampere University Hospital, Tampere, Finland. hannu.kuokkanen@pshp.fi
authors.forename: H
authors.initials: H
authors.lastname: Kuokkanen
authors.forename: A
authors.initials: A
authors.lastname: Mikkola
authors.forename: R H
authors.initials: RH
authors.lastname: Nyberg
authors.forename: M H
authors.initials: MH
authors.lastname: Vuento
authors.forename: I
authors.initials: I
authors.lastname: Kaartinen
authors.forename: T
authors.initials: T
authors.lastname: Kuoppala
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002081:Buttocks; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000601:surgery*; D010502:Perineum / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014844:Vulva / Q000601:surgery*; D014846:Vulvar Neoplasms / Q000601:surgery*