Department of Plastic Surgery, Tampere University Hospital, Tampere, Finland.
Scand J Surg. 2013;102(1):32-5. doi: 10.1177/145749691310200107.
Soft-tissue reconstruction of the vulva following resection of malignancies is challenging. The function of perineal organs should be preserved and the reconstructed area should maintain an acceptable cosmetic appearance. Reconstruction with local flaps is usually sufficient in the primary phase after a radical vulvectomy. Numerous flaps have been designed for vulvar reconstruction usually based on circulation from the internal pudendal artery branches. In this paper we introduce our modification of the gluteal fold V-Y advancement flap as a primary reconstruction after a radical vulvectomy.
Twenty-two patients were operated with a radical vulvectomy because of vulvar malignancies. The operation was primary in eight and secondary in 14 patients. The reconstruction of the vulva was performed in the same operation for each patient.
All flaps survived completely. Wound complications were registered in three patients. Late problems with urinary stream were corrected in two patients. A local recurrence of the malignancy was observed in six patients during the follow-up period.
Gluteal fold flap is easy to perform, has a low rate of complications and gives good functional results. Even a large defect can be reconstructed reliably with this method. A gluteal fold V-Y advancement flap is sensate and our modification allows the flap to be transposed with lesser dissection as presented before.
外阴恶性肿瘤切除术后的软组织重建极具挑战性。应保留会阴部器官的功能，且重建区域应保持可接受的美容外观。根治性外阴切除术的初级阶段，通常采用局部皮瓣进行重建。为外阴重建设计了许多皮瓣，通常基于阴部内动脉分支的循环。本文介绍了我们对臀褶 V-Y 推进皮瓣的改良，将其作为根治性外阴切除术的主要重建方法。
22 例外阴恶性肿瘤患者接受根治性外阴切除术。8 例为原发性手术，14 例为继发性手术。每位患者在同一手术中进行外阴重建。
所有皮瓣均完全存活。3 例患者出现伤口并发症。2 例患者的尿流问题在后期得到纠正。6 例患者在随访期间局部复发恶性肿瘤。
臀褶皮瓣易于操作，并发症发生率低，功能效果良好。即使是较大的缺损，也可以通过这种方法可靠地重建。臀褶 V-Y 推进皮瓣具有感觉功能，我们的改良方法可减少皮瓣的分离，与之前报道的方法相似。
