A fasciocutaneous flap for vaginal and perineal reconstruction

A skin and fascia flap from the medial thigh is proposed for vaginal and perineal reconstruction. Dissection, vascular injection, and radiographs of 20 fresh cadaver limbs uniformly demonstrated the presence of a communicating suprafascial vascular plexus in the medial thigh. Three to four nonaxial...

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Published inPlastic and reconstructive surgery (1963) Vol. 80; no. 1; p. 95
Main Authors Wang, T N, Whetzel, T, Mathes, S J, Vasconez, L O
Format Journal Article
LanguageEnglish
Published United States 01.07.1987
Subjects
Adult
Female
Humans
Middle Aged
Pelvic Exenteration - rehabilitation
Perineum - surgery
Radiation Injuries - surgery
Surgical Flaps
Vagina - radiation effects
Vagina - surgery
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Summary:A skin and fascia flap from the medial thigh is proposed for vaginal and perineal reconstruction. Dissection, vascular injection, and radiographs of 20 fresh cadaver limbs uniformly demonstrated the presence of a communicating suprafascial vascular plexus in the medial thigh. Three to four nonaxial vessels were consistently found to enter the proximal plexus from within 5 cm of the perineum. Preservation of these vessels permitted reliable elevation of a 9 X 20 cm fasciocutaneous flap without using the gracilis muscle as a vascular carrier. Fifteen flaps in 13 patients were used for vaginal replacement and coverage of vulvectomy, groin, and ischial defects. Depending on the magnitude of the defect, simultaneous and independent elevation of the gracilis muscle provided additional vascularized coverage as needed. Our experience indicates that the medial thigh fasciocutaneous flap is a durable, less bulky, and potentially sensate alternative to the gracilis musculocutaneous flap for vaginal and perineal reconstruction.
ISSN:0032-1052
DOI:10.1097/00006534-198707000-00015