Reconstruction of perineal defects

Abstract

Modern developments have led to an increased expectation in improved quality of life as the main goal of reconstruction, therefore necessitating surgery with less morbidity and early return to normal activity. Progress in microsurgical procedures has been the main recent advance in perineal reconstruction and, in future, refinements in perforator flap design and tissue engineering techniques will lead to even better reconstructions.

Transvaginal Small Bowel Evisceration following Abdominoperineal Resection

“…The vertical rectus abdominis myocutaneous flap (VRAM) is a common technique used in reconstruction of the perineal defects. VRAM flap has advantages such as long pedicle, large volume and surface area, and low incidence of necrosis [ 12 ].…”

Reconstruction of Large Defects in the Perineal Area Using Multiple Perforator Flaps

“…For successful reconstruction of perineal defects, various surgical options have been described [ 1 6 ]. Conventional methods, such as gracilis muscle flaps, gluteus muscle flaps, and rectus abdominis myocutaneous flaps are useful options for covering perineal defects [ 1 6 ]. Free flaps can be another option [ 7 ].…”

“…Perineal defects are commonly encountered during the treatment of conditions such as malignancy in the perineal area, infectious disease, and trauma [ 1 ]. Radical treatments are usually indicated (e.g., wide excisions), which result in large, soft tissue defects.…”

“…Radical treatments are usually indicated (e.g., wide excisions), which result in large, soft tissue defects. Successful reconstruction of soft tissue defects requires adequate skin coverage with well-vascularized tissue to fill the dead space [ 1 ]. Although small defects are relatively easy to cover using methods such as primary repair and skin grafting, coverage of large defects in the perineal area is challenging due to the complicated anatomy and the need for functional preservation [ 2 ].…”

Avaliação da sensibilidade cutânea do retalho perfurante da artéria pudenda interna nas reconstruções perineais

“…De forma geral, a reconstrução do períneo pode ser realizada pela aproximação e fechamento primário 28,36,37 e, em casos selecionados de defeitos superficiais, com a aplicação de enxertos de pele 38,39,40 . Por sua vez, os retalhos são os métodos mais utilizados para reconstrução perineal, com destaque para os retalhos musculares 41 , miocutâneos 34,42,43,44 , fasciocutâneos 45,46,47,48 e retalhos perfurantes 3,15,16,49,50,51 .…”