title: Profunda artery perforator based V-Y rotation advancement flap for total vulvectomy defect reconstruction--A case report and literature review.
abstract: Reconstruction of total vulvectomy defect represents a challenge, and reconstructive methods include skin graft, local skin flap, musculocutanous flap, and pedicled perforator flap. We report a case of a 63-year-old patient affected by extramammary Paget's disease of vulva who underwent total vulvectomy receiving reconstruction with bilateral profunda artery perforator based V-Y rotation advancement flap. The literature about vulva reconstruction was reviewed. This innovative flap design combined the classic rotation flap and V-Y advancement flap with inclusion of the profunda artery perforators to augment the flap blood supply. Besides, the internal pudendal nerve was preserved to maintain the sensation of the neo-uvula. The flap survived completely without major post-operative complications with 9-months follow-up. Profunda artery perforator based V-Y rotation advancement flap may represent a valuable option in total vulvectomy defect reconstruction.
authors.forename: Yen-Chou
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Mario F
authors.initials: MF
authors.lastname: Scaglioni
authors.affiliation: Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Yur-Ren
authors.initials: YR
authors.lastname: Kuo
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D010145:Paget Disease, Extramammary / Q000601:surgery*; D061525:Perforator Flap / Q000098:blood supply; D019651:Plastic Surgery Procedures / Q000379:methods*; D014844:Vulva / Q000601:surgery*; D014846:Vulvar Neoplasms / Q000601:surgery*