The partial gluteus maximus musculocutaneous turnover flap. An alternative concept for simultaneous reconstruction of combined defects of the posterior perineum/sacrum and the posterior vaginal wall

Germann, G.; Cedidi, C.; Petracic, A.; Herrfarth, C.; Kallinowski, F.

doi:10.1054/bjps.1998.0124

Cited by 16 publications

(6 citation statements)

References 16 publications

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“…Most reported the use of split-thickness skin grafts to lengthen a foreshortened vagina (especially after treatment for gynecologic cancers) [11][12][13]. Other Authors evaluated the use of myocutaneous grafts to reconstruct the perineum and/or posterior vagina or the use of dilatators [14,15].…”

Section: Discussionmentioning

confidence: 99%

Severe Vaginal Stenosis Simulating a Transverse Septum with Huge Hematocolpos in an Hiv-patient: How to Make a Break in the Wall?

Spinelli¹

2014

J Clin Case Rep

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Introduction: Vaginal infections are the most commonly reported condition among women with HIV/AIDS and such infections often represent the most common initial manifestation of the illness. As a consequence, post-infective early and late complications are frequently reported in these patients. Vaginal stenosis has been reported as a rare late complication of severe vaginal infections. The vaginoscopic treatment with miniaturized instruments of a severe vaginal stenosis with huge hematocolpos in a HIV-infected woman is here reported.\ud Case presentation: A 38 year-old HIV-infected woman was referred to our Emergency Unit because of severe pelvic pain, increasing over time, beginning a week before, after a sexual intercourse. At physical and ultrasonographic examination, complete vaginal stenosis up to the vaginal vestibule (miming a transversal vaginal septum) with a giant haematocolpos was diagnosed. She was scheduled for traditional surgical treatment in the operating room with Hegar dilatators but the procedure was unsuccessful. The patient was then scheduled for an operative vaginoscopy in office setting by means of a 5mm oval-profile hysteroscope. The use of 5Fr bipolar electrode and mechanical instruments allowed to make a break in the “wall”, thus allowing the complete drainage of the haematocolpos without any significant complication.\ud Conclusion: Vaginoscopy with miniaturized instruments represent a safe, convenient, and efficient therapeutic modality that can be used in patients with a restrictive vaginal opening or narrow vaginal canal

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Section: Discussionmentioning

confidence: 99%

Severe Vaginal Stenosis Simulating a Transverse Septum with Huge Hematocolpos in an Hiv-patient: How to Make a Break in the Wall?

Spinelli¹

2014

J Clin Case Rep

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“…Although the use of the gluteal region has been described previously for this role, this use has been limited to the musculocutaneous gluteal flap or as an advancement flap, which are each limited by the need to include muscle harvest or the advancement of irradiated tissue into the defect. [3][4][5] While popularized for use in breast reconstruction as free flaps, 15 pedicled gluteal artery perforator flaps have been described for local advancement into defects such as sacral pressure ulcer defects 16,17 and other lumbosacral defects. 6,7 Judge et al 9 described the gluteal artery perforator flap for this role, however, used these as advancement flaps, with irradiated tissue necessarily used in the flap, and contributing to complications such as wound dehiscence and infection.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] The gluteal artery perforator flap has been used locally for lumbosacral defects [6][7][8] and as a perforator-based advancement flap for perineal reconstruction, 9 however, these are associated with advancement of irradiated tissue into the defect and the associated complications. We present our technique of superior and inferior gluteal artery perforator (SGAP or IGAP) flaps for transposition to reconstruct such defects.…”

mentioning

confidence: 99%

Perineal and posterior vaginal wall reconstruction with superior and inferior gluteal artery perforator flaps

Wagstaff¹,

Rozen

Whitaker

et al. 2009

Microsurgery

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Perineal and posterior vaginal wall reconstruction following abdominoperineal and local cancer resection entails replacement of volume between the perineum and sacrum and restoration of a functional vagina. Ideal local reconstructive options include those which avoid functional muscle sacrifice, do not interfere with colostomy formation, and avoid the use of irradiated tissue. In avoiding the donor site morbidity of other options, we describe a fasciocutaneous option for the reconstruction of the perineum and posterior vaginal wall. We present our technique of superior and inferior gluteal artery perforator (SGAP or IGAP) flaps to reconstruct such defects. Fourteen patients between 2004 and 2008 underwent 11 SGAP and three IGAP flaps. There were no flap failures or partial flap losses and no postoperative hernias. All female patients reported resumption of sexual intercourse following this procedure. Our experience in both the immediate and delayed setting is that this technique produces a good functional outcome with low donor-site morbidity.

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“…3 However, the gluteus maximus myocutaneous flap can interfere with stair climbing and single-limb support. To overcome this problem, different perforator flaps based on the superior (SGAP) and inferior gluteal arteries (IGAP) have been reported.…”

Section: Dear Sirmentioning

confidence: 99%

“…These include traditional muscle flaps, such as gracillis muscle flap, transverse abdominis muscle flap, and tensor fascia lata flap, and fasciocutaneous flaps, such as medial thigh flaps and gluteal flaps. 3 However, these conventional flaps have several disadvantages. The pedicle is remote from the perineal region and the flaps lack mobility.…”

Section: Orlando García Duquementioning

confidence: 99%

Posterior vaginal wall reconstruction: An easy and reliable solution

Duque

Sánchez

Vega

et al. 2015

Journal of Plastic, Reconstructive & Aesthetic Surgery

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The partial gluteus maximus musculocutaneous turnover flap. An alternative concept for simultaneous reconstruction of combined defects of the posterior perineum/sacrum and the posterior vaginal wall

Cited by 16 publications

References 16 publications

Severe Vaginal Stenosis Simulating a Transverse Septum with Huge Hematocolpos in an Hiv-patient: How to Make a Break in the Wall?

Severe Vaginal Stenosis Simulating a Transverse Septum with Huge Hematocolpos in an Hiv-patient: How to Make a Break in the Wall?

Perineal and posterior vaginal wall reconstruction with superior and inferior gluteal artery perforator flaps

Posterior vaginal wall reconstruction: An easy and reliable solution

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