Evaluation of cutaneous sensibility of the internal pudendal artery perforator (IPAP) flap after perineal reconstructions

Coltro, Pedro Soler; Ferreira, Marcus Castro; Busnardo, Fábio de Freitas; Olivan, Marcelo V.; Ueda, Thiago; Grillo, Victor A.; Marques, Carlos Frederico Sparapan; Nahas, Caio Sérgio Rizkallah; Nahas, Sérgio Carlos; Gemperli, Rolf

doi:10.1016/j.bjps.2014.09.049

Cited by 20 publications

(8 citation statements)

References 39 publications

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“…For the study of cutaneous sensibility, Dellon et al developed the PSSD™, a device capable of quantifying cutaneous pressure threshold applied to the skin, needed for the patient to feel the stimulus from one or two points, both static (slow adapting fibers) and moving (fast adapting fibers) . PSSD™ has been successfully used for neuropathy studies on the hands and lower limbs, in addition to study of cutaneous sensibility changes after surgeries …”

Section: Discussionmentioning

confidence: 99%

Chimerical anterolateral thigh flap for plantar reconstruction

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Chimerical anterolateral thigh flap for plantar reconstruction

et al. 2015

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“…Flaps based on internal pudendal artery used for vulvovaginal and perineal reconstruction have been used since the 1980s. IPAP flaps are widely used because they are easy to dissect, have similar skin, and are reliable with minimal donor site morbidity (Coltro et al, 2015; Hagerty et al, 1988). However, the bilateral flaps are often required because the size of the flap that can be obtained is small, and in extensive cases, to cover even the bilateral flaps are often difficult.…”

Section: Discussionmentioning

confidence: 99%

Propeller posteromedial thigh perforator flaps for coverage of extensive perineal defects

et al. 2021

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Background Reconstruction of perineal defect is challenging. The goal of reconstruction is to maintain normal function with good esthetic outcomes. Coverage of the perineal defect is often difficult with one loco‐regional flap when the size of defect is very extensive. In this article, clinical applications of the propeller posteromedial thigh perforator (PMTP) flap for extensive perineal defects were described. Patients and Methods Eight patients underwent perineal reconstruction with propeller PMTP flaps from March 2013 to December 2018. The average age of the patients was 65 years (range: 52–80 years). The causes of the defects included infection and skin cancers. The perforator was a branch of deep femoral artery. The flap was harvested as a perforator‐based flap and rotated 180° to the defect area (propeller flap design). Results The average flap size was 256.5 cm2 (range: 136–400 cm2) and average follow‐up period was 22.4 months (range: 6–48 months). All flaps survived after surgery without major complications. The donor sites were all primarily closed and the patients were all satisfied during the follow‐up period. Conclusion The propeller PMTP flap is an adequate new option for reconstructing extensive perineal defects. The flap avoids the need for microanastomosis and replaces the defect with similar tissue.

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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%

“… 9 , 52 They can be designed in different variations (eg, transposition, rotation, V-Y advancement, rhomboid) and can be sensate, with innervation from the posterior labial nerve and the perineal branches of the posterior cutaneous nerve of the thigh. 19 , 20 , 27 , 39 , 53 – 55 Donor sites up to 7 cm in the gluteal fold can be closed primarily, and staged reconstruction with a multizone design can be planned. Despite concerns that the flap could increase lymphatic spreading after tumor removal, current clinical evidence suggests its safety in post-oncological reconstructions.…”

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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Evaluation of cutaneous sensibility of the internal pudendal artery perforator (IPAP) flap after perineal reconstructions

Cited by 20 publications

References 39 publications

Chimerical anterolateral thigh flap for plantar reconstruction

Chimerical anterolateral thigh flap for plantar reconstruction

Propeller posteromedial thigh perforator flaps for coverage of extensive perineal defects

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

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