The use of tissue flaps as an adjunct to pelvic surgery

Galandiuk, Susan; Jorden, Jeffrey; Mahid, Suhal S.; McCafferty, Michael H.; Tobin, Gordon R.

doi:10.1016/j.amjsurg.2005.05.009

Cited by 32 publications

(26 citation statements)

References 16 publications

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“…Surgical solutions for reconstruction range from secondary healing to free tissue transfer, with pedicled flaps typically being the first choice [12]. Primary goals of reconstruction are tension free skin closure, with good quality tissues, maintenance of vaginal and urethral introitus without shrinkage and deviation from their central position, restoration of the anovaginal partition, and simultaneous closure of associated defects, such as mons pubis or inguinal defects if necessary.…”

Section: Introductionmentioning

confidence: 99%

Surgical therapy of vulvar cancer: how to choose the correct reconstruction?

et al. 2016

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ObjectiveTo create a comprehensive algorithmic approach to reconstruction after vulvar cancer ablative surgery, which includes both traditional and perforator flaps, evaluating anatomical subunits and shape of the defect.MethodsWe retrospectively reviewed 80 cases of reconstruction after vulvar cancer ablative surgery, performed between June 2006 and January 2016, transferring 101 flaps. We registered the possibility to achieve the complete wound closure, even in presence of very complex defects, and the postoperative complications. On the basis of these experience, analyzing the choices made and considering the complications, we developed an algorithm to help with the selection of the flap in vulvoperineal reconstruction after oncologic ablative surgery for vulvar cancer.ResultsWe employed eight types of different flaps, including 54 traditional fasciocutaneous V-Y flaps, 23 rectus abdominis myocutaneous flaps, 11 anterolateral thigh flaps, three V-Y gracilis myocutaneous flaps, three free style perforators V-Y flaps from the inner thigh, two Limberg flaps, two lotus flaps, two deep inferior epigastric artery perforator flap, and one superficial circumflex iliac artery perforator flap. The structures most frequently involved in resection were vulva, perineum, mons pubis, groins, vagina, urethra and, more rarely, rectum, bladder, and lower abdominal wall.ConclusionThe algorithm we implemented can be a useful tool to help flap selection. The key points in the decision-making process are: anatomical subunits to be covered, overall shape and symmetry of the defect and some patient features such as skin laxity or previous radiotherapy. Perforator flaps, when feasible, must be considered standard in vulvoperineal reconstruction, although in some cases traditional flaps remain the best choice.

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Section: Introductionmentioning

confidence: 99%

Surgical therapy of vulvar cancer: how to choose the correct reconstruction?

et al. 2016

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“…Other surgeons believe that VRAM flaps are preferable because they have a more reliable skin paddle and provide more bulk to obliterate dead space. 3,5,6,8,12 VRAM flaps also have excellent viability because of their robust and consistent vascularity, preclude creation of an additional donor-site wound location, and have a long arc of rotation to reach distal defects.…”

mentioning

confidence: 98%

“…Immediate flap reconstruction for the large pelvic/perineal defects created by resection has been shown to result in fewer wound complications than primary closure methods. [1][2][3][4][5][6][7] Flaps reduce complications by obliterating pelvic dead space; recruiting healthy, well-vascularized tissue into the region, which has commonly been irradiated and contaminated; and interposing a flap skin between irradiated perineal wound edges. 1,[3][4][5][6][7][8][9][10][11] Two of the most commonly used groups of flaps for the repair of abdominoperineal resection and pelvic exenteration defects are pedicled thigh flaps 2,8,10,11 and pedicled rectus abdominis flaps, 1,3,4,6,12-14 particularly inferiorly based vertical rectus abdominis myocutaneous (VRAM) flaps.…”

mentioning

confidence: 99%

Surgical Outcomes of VRAM versus Thigh Flaps for Immediate Reconstruction of Pelvic and Perineal Cancer Resection Defects

Nelson

Butler

2009

Plastic &Amp; Reconstructive Surgery

178

120

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“…To prevent such complications, many repair techniques have been reported, such as primary suture, repair using myocutaneous flap and prosthetic mesh reconstruction [1], [5], [6], [7], [8].…”

Section: Discussionmentioning

confidence: 99%

Surgery for chronic mesh infection occurred 10 years after sacrectomy − Mesh resection and mesentric leaf repair: A case report

Koyama

Miyagawa

Yamamoto

et al. 2017

International Journal of Surgery Case Reports

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HighlightsAn 83-years old woman underwent sacrectomy combined with mesh reconstruction for chordoma suffered chronic mesh infection and bowel penetration 10 years after surgery.This is the first report of mesh infection after sacrectomy and its surgical strategy.We performed subtotal mesh resection and Mesenteric leaf repair for pelvic reconstruction.Mesentric leaf repair might be a useful procedure for pelvic reconstruction when the use of a mesh has to be avoided.

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The use of tissue flaps as an adjunct to pelvic surgery

Cited by 32 publications

References 16 publications

Surgical therapy of vulvar cancer: how to choose the correct reconstruction?

Surgical therapy of vulvar cancer: how to choose the correct reconstruction?

Surgical Outcomes of VRAM versus Thigh Flaps for Immediate Reconstruction of Pelvic and Perineal Cancer Resection Defects

Surgery for chronic mesh infection occurred 10 years after sacrectomy − Mesh resection and mesentric leaf repair: A case report

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