title: [EFFECTIVENESS OF DEEP INFERIOR EPIGASTRIC ARTERY PERFORATOR FLAP FOR REPAIR OF PERINEAL AND PERIANAL CICATRICIAL CONTRACTURE].
abstract: OBJECTIVE
  To discuss the effectiveness of deep inferior epigastric artery perforator flap to repair perineal and perianal cicatricial contracture.
  
  
  METHODS
  Between March 2007 and December 2013, 23 patients with perineal and perianal cicatricial contracture were treated with deep inferior epigastric artery perforator flap. There were 15 males and 8 females, aged from 21 to 62 years (mean, 42 years). Burn depth was III degree. The burning scars involved in the fascia, even deeper, which was rated as peripheral type (mild stenosis of the anal region and perianal cicatricial contracture) in 13 cases and as central type (severe stenosis of the anal region and anal canal with shift or defect of external genitalia) in 10 cases. All patients had limited hip abduction and squatting. Repair operation was performed at 3 months to 2 years (mean, 6 months) after wound healing. The size of soft tissue defects ranged from 10 cmx6 cm to 28 cm x 13 cm after scar excision and release. The size of flaps ranged from 12 cmx7 cm to 30 cmx15 cm. The donor site was sutured directly in 16 cases and repaired by autograft of skin in 7 cases.
  
  
  RESULTS
  The flap had distal necrosis, distal cyanosis, and spotted necrosis in 1 case, 2 cases, and 1 case respectively, which were cured after symptomatic treatment; the other flaps survived and wound healed primarily. Twenty-one patients were followed up 6 months to 2 years (mean, 1 year). Nineteen patients had good appearance of the perinea and position of external genitalia, normal function of defecation function; stenosis of the anal region was relived, and the flaps had good texture and elasticity. Linear scar contracture was observed at the edge of flap in 2 cases, and the appearance of the perineum was restored after Z plasty. The hip abduction reached 30-40°. No abdominal hernia was found at donor site.
  
  
  CONCLUSIONS
  Deep inferior epigastric artery perforator flap has stable blood supply and flexible design, which is similar to the perianal and perineal tissues. The good effectiveness can be obtained to use this flap for repair of perineal and perianal cicatricial contracture.
authors.forename: Liping
authors.initials: L
authors.lastname: Du
authors.forename: Xiaobo
authors.initials: X
authors.lastname: You
authors.forename: Kuangyun
authors.initials: K
authors.lastname: Tang
authors.forename: Rong
authors.initials: R
authors.lastname: Fu
mesh_terms: D001003:Anal Canal; D002056:Burns; D002921:Cicatrix / Q000601:surgery*; D003286:Contracture / Q000601:surgery*; D019074:Epigastric Arteries; D005260:Female; D006801:Humans; D008297:Male; D010388:Pelvis; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D010502:Perineum; D019651:Plastic Surgery Procedures; D012867:Skin; D016038:Skin Transplantation / Q000379:methods*; D014945:Wound Healing