Double-sided folded internal pudendal artery perforator flap for the repair of a recurrent rectovaginal fistula

Lee, Sang Keon; Lee, Yong Seok; Song, Seung Yong; Lee, Won Jai; Lee, Jun Young

doi:10.5999/aps.2017.00269

Cited by 3 publications

(2 citation statements)

References 5 publications

(8 reference statements)

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“… 12 – 14 , 19 , 20 , 25 , 27 , 30 , 33 , 34 , 37 – 46 The advantages (and disadvantages) of these nonaxial pattern flaps are well known. 12 – 14 , 20 , 25 , 27 , 30 , 33 , 34 , 37 – 46 Their use has been suggested as an ideal option for the reconstruction of moderate to moderate-severe perineal defects that do not cross the midline (eg, semi-vulvar reconstruction), and that do not require the “bulkiness” of more invasive muscle or musculocutaneous flaps (eg, gracilis flap, rectus abdominis muscle flap, etc. ), and that cannot be repaired with minor local techniques.…”

Section: Discussionmentioning

confidence: 99%

Gender-specific Anatomical Distribution of Internal Pudendal Artery Perforator: A Radiographic Study for Perineal Reconstruction

Sonda

Monticelli

Venezia

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: Cancer, trauma, infection, or radiation can cause perineal defects. Fasciocutaneous flaps based on perforator vessels (PV) from the internal pudendal artery (IPA) provide an ideal reconstructive option for moderate defects. We hypothesized that, due to gender differences in the pelvic–perineal region, the anatomical distribution of PV differs between genders. Methods: Computed tomography angiographies from male and female patients without pelvic–perineal pathologies were retrospectively analyzed to study the vascular anatomy of the IPA. The number, size, type, and distribution of PV were recorded and compared between genders. Four anatomical regions were defined to describe the distribution of PV on each perineal side: anterior (A), anterior-central (AC), central-posterior (CP), and posterior (P). Results: A total of 63 computed tomography angiographies were analyzed (men, 31; women, 32). Each IPA provides 2 ± 1 PV and 5 ± 2 terminal (cutaneous) branches: in both genders, 85% of PV are septocutaneous (15% musculocutaneous). In women, 70.5% of PV are located in AC, 28.2% in CP, 1.2% in A, and 0% in P: average diameter of the PV is 2.4 ± 0.3 mm. In men, 53.7% of PV are located in CP, 43.1% in AC, 3.3% in A, and 0% in P: average diameter of the PV is 2.8 ± 0.5 mm. Gender-specific differences in anatomical distribution of PV are significant (P < 0.001). Conclusions: Number, size, and type of terminal branches of PV of the IPA are consistent between genders, but their distribution is different, with women having an anterior predominance. Knowledge of gender-specific anatomy can guide preoperative planning and intraoperative dissection in flap-based perineal reconstruction

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Section: Discussionmentioning

confidence: 99%

Gender-specific Anatomical Distribution of Internal Pudendal Artery Perforator: A Radiographic Study for Perineal Reconstruction

Sonda

Monticelli

Venezia

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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show abstract

“…Gluteal perforator flaps have good vasculature without causing any notable functional deformities. 94 Omentum is versatile and can be mobilised to come all the way down to the perineal skin but is not always retrievable. Our centre demonstrated good results in seven patients who underwent a combined laparoscopic and perineal omental interposition and perineal repair.…”

Section: Common Techniquesmentioning

confidence: 99%