title: Vulvar and vaginal reconstruction using the "angel wing" perforator-based island flap.
abstract: OBJECTIVE
  Vulvar and vaginal reconstruction can be challenging for the reconstructive surgeon. The reconstructive goal is to provide wound healing, adequate function, and acceptable appearance. In the present study, we introduce a new design called the "angel wing" flap, which is a modification of a transposition flap and is based on the perforator concept for vulvar and vaginal reconstruction.
  
  
  METHODS
  From January 2002 to December 2013, 23 women underwent reconstruction of vulvar and vaginal defects. Causative factors were vulvar cancer in 14 patients, extramammary Paget's disease in 2, vulvar dysplasia in 5, and combined vulvar and vaginal cancer in 2 patients.
  
  
  RESULTS
  A total of 41 flaps were applied. All patients underwent surgical reconstruction in a single step using the "angel wing" flap. Flap size ranged from 4×7 to 13×6cm(2) and the operative duration for reconstructive surgery ranged from 30 to 100min. All the flaps survived with good coverage of the defect. Mean follow-up time after the procedure was 16.1months (range, 6-30months).
  
  
  CONCLUSIONS
  In this article, we introduce a simple and easy reconstructive procedure of the "angel wing" flap. For restoring function, as well as for esthetic purposes, the flap was designed in accordance with the defect since the natural contour of the vulva and vagina is three-dimensional.
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Sang Wha
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Won Moo
authors.initials: WM
authors.lastname: Lee
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Jeong Tae
authors.initials: JT
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea. Electronic address: younhwank@daum.net.
authors.forename: Youn Hwan
authors.initials: YH
authors.lastname: Kim
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D014621:Vagina / Q000473:pathology / Q000601:surgery; D014625:Vaginal Neoplasms / Q000601:surgery*; D014844:Vulva / Q000473:pathology / Q000601:surgery; D014846:Vulvar Neoplasms / Q000601:surgery*
keywords: Perforator flap; Reconstruction; Vagina; Vulva