Reconstruction of Large Defects in the Perineal Area Using Multiple Perforator Flaps.
BACKGROUND
Perineal defects are commonly encountered during the treatment of conditions such as malignancy, infectious disease, and trauma. Covering large defects in the perineal area is challenging due to its complicated anatomy and the need for functional preservation.


METHODS
Fourteen patients who underwent reconstructive surgery with multiple perforator flaps for defects >100 cm(2) in the perineal area were included in this retrospective cohort study. Characteristics of the perforator flap operation and postoperative outcomes were reviewed.


RESULTS
Reconstruction was performed using 2 perforator flaps for 13 patients and 3 perforator flaps for 1 patient. Internal pudendal artery perforator flaps were mainly used for covering the defects. The average defect size was 176.3±61.8 cm(2) and the average size of each flap was 95.7±31.9 cm(2). Six patients had minor complications, such as wound dehiscence and partial necrosis of the flap margin, which were corrected with simple revision procedures.


CONCLUSIONS
Multiple perforator flaps can be used to achieve successful reconstructions of large perineal defects that are difficult to reconstruct with other coverage methods.
Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
Ki Wook
KW
Sung
Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
Won Jai
WJ
Lee
Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
In Sik
IS
Yun
Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
Dong Won
DW
Lee
Perforator flap; Perineum; Reconstructive surgical procedures
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