Jędrasiak Anna, Juniewicz Honorata, Raczek Wiktoria, Srokowska Alicja, Kozłowski Mateusz, Cymbaluk-Płoska Aneta
Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland.
J Clin Med. 2025 Jun 23;14(13):4456. doi: 10.3390/jcm14134456.
Vulvar and perineal reconstruction represents a significant surgical challenge, particularly in the context of oncological resections, trauma, or postpartum injuries. Vulvar cancer, predominantly squamous cell carcinoma, often necessitates extensive resections, leading to significant tissue defects and high rates of postoperative complications. Reconstructive procedures, encompassing skin grafts and local, regional, and distant flaps, are intended to restore the anatomical structure, protect internal organs, and enhance functional outcomes and quality of life. The selection of technique is contingent upon the dimensions of the defect, its location, the patient's condition, and the availability of suitable tissue. The management of minor defects can be accomplished through local advancements, while more extensive or complex cases necessitate the utilization of musculocutaneous (e.g., VRAM) or fasciocutaneous (e.g., ALT) flaps. The present article provides a review of surgical methods of vulvar and perineal reconstruction, with a focus on indications, techniques, and potential complications.
外阴和会阴重建是一项重大的外科挑战，尤其是在肿瘤切除、创伤或产后损伤的情况下。外阴癌，主要是鳞状细胞癌，常常需要广泛切除，导致显著的组织缺损和较高的术后并发症发生率。重建手术包括皮肤移植以及局部、区域和远处皮瓣移植，旨在恢复解剖结构、保护内部器官，并改善功能结局和生活质量。技术的选择取决于缺损的大小、位置、患者状况以及合适组织的可用性。较小缺损的处理可通过局部推进来完成，而更广泛或复杂的病例则需要使用肌皮瓣（如腹直肌肌皮瓣）或筋膜皮瓣（如股前外侧皮瓣）。本文对外阴和会阴重建的手术方法进行综述，重点关注适应证、技术及潜在并发症。
