Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea.
Gynecol Oncol. 2010 Sep;118(3):313-6. doi: 10.1016/j.ygyno.2010.05.007. Epub 2010 Jun 9.
To reconstruct the perineal region, including the urogenital and anal triangle that differ from each other in tissue characteristics and function, we applied pudendal artery perforator flaps with a bilobed flap design. This bilobed flap design could improve the arc of flap rotation and the mobility of the flap so it could cover wide and deep defects. Moreover, it could preserve the characteristics of each triangle.
This study enrolled a total of 15 female patients who had undergone perineal reconstruction with pudendal artery perforator flaps. Seven of them had vulva cancer, seven others had extramammary Paget's disease and the remaining one patient had rectovaginal fistula. We examined the location and shape of the defects, flap designs and their clinical courses.
All flaps survived during the entire follow-up period. The flap sizes ranged from 3x4 to 13x12 cm, and the follow-up period was 4.6 months on average. Bilobed flaps were used in nine patients, and unilobed flaps were used in six patients. The reconstructed areas were in good functional and aesthetic conditions.
We used a bilobed pudendal artery perforator flap according to the location and shape of defect areas in the perineal region. As a result, we could preserve the functional, morphological and cosmetic characteristics of the defect areas.
为了重建会阴区域，包括在组织特征和功能上彼此不同的泌尿生殖和肛门三角，我们应用了阴部动脉穿支皮瓣的双叶瓣设计。这种双叶瓣设计可以改善皮瓣的旋转弧度和活动度，从而覆盖更广泛和更深的缺损。此外，它还可以保留每个三角的特征。
本研究共纳入 15 名接受阴部动脉穿支皮瓣会阴重建的女性患者。其中 7 例为外阴癌，7 例为乳房外 Paget 病，1 例为直肠阴道瘘。我们检查了缺损的位置和形状、皮瓣设计及其临床过程。
所有皮瓣在整个随访期间均存活。皮瓣大小从 3x4 到 13x12cm 不等，平均随访时间为 4.6 个月。9 例患者采用双叶瓣，6 例患者采用单叶瓣。重建区域功能和美观状况良好。
我们根据会阴区域缺损的位置和形状，采用了双叶阴部动脉穿支皮瓣。结果，我们能够保留缺损区域的功能、形态和美容特征。
