Overcoming the Three-Dimensional Complexity of Vulvar Defects: A Stepwise, Multi-Flap Approach
Complex vulvar defects are challenging owing to their three-dimensional characteristics. We introduce a combined flap approach to maximize the use of locoregional tissues. Four patients had defects involving the vaginal wall, anal canal, and perineum, with a size range of 108 to 157 cm2. The outcome...
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| Language: | English |
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Thieme Medical Publishers, Inc.
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| Series: | Archives of Plastic Surgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-2606-9515 |
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| author | Chuan-Han Ang Walter J.X. Tan Bien-Keem Tan Khong-Yik Chew |
| author_facet | Chuan-Han Ang Walter J.X. Tan Bien-Keem Tan Khong-Yik Chew |
| author_sort | Chuan-Han Ang |
| collection | DOAJ |
| description | Complex vulvar defects are challenging owing to their three-dimensional characteristics. We introduce a combined flap approach to maximize the use of locoregional tissues. Four patients had defects involving the vaginal wall, anal canal, and perineum, with a size range of 108 to 157 cm2. The outcomes were analyzed using a questionnaire regarding micturition, defecation, coital function, introitus opening, and aesthetics. For the vulva, the gluteal fold flap was the primary flap, which was augmented by the mons pubis rotation flap, gracilis muscle flap, pudendal thigh flap, and medial thigh VY advancement flap. The perianal skin and anal defects were covered by the gluteal fold and buttock VY advancement flaps. Patients' satisfaction scores were favorable on follow-up. Our multi-flap approach optimized the aesthetic and functional results of combined vulvar–anal defects. |
| format | Article |
| id | doaj-art-23412d2f0d884472bf752b39d78e6697 |
| institution | OA Journals |
| issn | 2234-6163 2234-6171 |
| language | English |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Archives of Plastic Surgery |
| spelling | doaj-art-23412d2f0d884472bf752b39d78e66972025-08-20T02:36:34ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-617110.1055/a-2606-9515Overcoming the Three-Dimensional Complexity of Vulvar Defects: A Stepwise, Multi-Flap ApproachChuan-Han Ang0https://orcid.org/0000-0003-0703-8522Walter J.X. Tan1https://orcid.org/0009-0008-4845-8033Bien-Keem Tan2https://orcid.org/0000-0002-7347-8713Khong-Yik Chew3https://orcid.org/0000-0002-1050-1613Department of Plastic, Reconstructive, and Aesthetic Surgery, Singapore General Hospital, SingaporeFaculty of Medicine, University of Queensland, Brisbane, Queensland, AustraliaDepartment of Plastic, Reconstructive, and Aesthetic Surgery, Singapore General Hospital, SingaporeDepartment of Plastic, Reconstructive, and Aesthetic Surgery, Singapore General Hospital, SingaporeComplex vulvar defects are challenging owing to their three-dimensional characteristics. We introduce a combined flap approach to maximize the use of locoregional tissues. Four patients had defects involving the vaginal wall, anal canal, and perineum, with a size range of 108 to 157 cm2. The outcomes were analyzed using a questionnaire regarding micturition, defecation, coital function, introitus opening, and aesthetics. For the vulva, the gluteal fold flap was the primary flap, which was augmented by the mons pubis rotation flap, gracilis muscle flap, pudendal thigh flap, and medial thigh VY advancement flap. The perianal skin and anal defects were covered by the gluteal fold and buttock VY advancement flaps. Patients' satisfaction scores were favorable on follow-up. Our multi-flap approach optimized the aesthetic and functional results of combined vulvar–anal defects.http://www.thieme-connect.de/DOI/DOI?10.1055/a-2606-9515extramammary Paget's diseasesquamous cell carcinomavulvar reconstruction |
| spellingShingle | Chuan-Han Ang Walter J.X. Tan Bien-Keem Tan Khong-Yik Chew Overcoming the Three-Dimensional Complexity of Vulvar Defects: A Stepwise, Multi-Flap Approach Archives of Plastic Surgery extramammary Paget's disease squamous cell carcinoma vulvar reconstruction |
| title | Overcoming the Three-Dimensional Complexity of Vulvar Defects: A Stepwise, Multi-Flap Approach |
| title_full | Overcoming the Three-Dimensional Complexity of Vulvar Defects: A Stepwise, Multi-Flap Approach |
| title_fullStr | Overcoming the Three-Dimensional Complexity of Vulvar Defects: A Stepwise, Multi-Flap Approach |
| title_full_unstemmed | Overcoming the Three-Dimensional Complexity of Vulvar Defects: A Stepwise, Multi-Flap Approach |
| title_short | Overcoming the Three-Dimensional Complexity of Vulvar Defects: A Stepwise, Multi-Flap Approach |
| title_sort | overcoming the three dimensional complexity of vulvar defects a stepwise multi flap approach |
| topic | extramammary Paget's disease squamous cell carcinoma vulvar reconstruction |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-2606-9515 |
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