title: The interrupted V-Y advancement flap for the reconstruction of the vulvovaginal defect.
abstract: BACKGROUND
  High-quality reconstruction of vulvovaginal defects after tumor excision is critical. Various techniques for vulvovaginal reconstruction have been described. However, these flaps are often bulky, and tip necrosis occasionally occurs. To reduce bulkiness and prevent flap necrosis, we have therefore developed an ideal approach using a fasciocutaneous flap that is advanced in a modified V-Y fashion.
  
  
  METHODS
  The V-Y flap is interrupted in the defect area by a bipedicled flap and therefore termed "the interrupted V-Y advancement flap".
  
  
  RESULTS
  We used the interrupted V-Y advancement flap to cover vulvovaginal defects in five patients who underwent surgical treatment for extramammary Paget's disease or carcinoma of the vulva. Each flap survived completely without complications.
  
  
  CONCLUSIONS
  This flap is easily elevated, not bulky, and reliable because it is supplied by the internal pudendal artery and vein without excessive skeletonization of the vascular pedicle; it also matches the local skin quality.
authors: Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan. ysakamoto@z8.keio.jp
authors: Yoshiaki
authors: Y
authors: Sakamoto
authors: Hideo
authors: H
authors: Nakajima
authors: Nobuaki
authors: N
authors: Imanishi
authors: Kazuo
authors: K
authors: Kishi
mesh_terms: D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D014844:Vulva / Q000601:surgery; D014846:Vulvar Neoplasms / Q000601:surgery*