Better Anatomical and Cosmetic Results Using Tunneled Lotus Petal Flap for Plastic Reconstruction After Demolitive Surgery for Vulvar Malignancy

Abstract

Tunneled lotus petal flap is safe, easy and fast to perform, has a low rate of complications, and good functional and cosmetic results. This technique represents an optimal solution for plastic reconstruction in case of primary or recurrent vulvar disease, or in case of introital stenosis after primary inadequate closure.

Lotus petal flap and vertical rectus abdominis myocutaneous flap in vulvoperineal reconstruction: a systematic review of differences in complications

“…Yii et al [14] were the first in 1996 to report on reconstruction using the LP flap. All but three of these studies are case series [14][15][16][17][18][19][20][21][22][23][24][25][26]. Only Negosanti et al [27], Confalonieri et al [18] and Thiele et al [28] reported a case control study in which a reconstruction with LP flaps was compared with other flaps.…”

“…About half of the studies (56.3%) were small studies (<20 patients), the largest was that of Confalonieri et al which included 106 patients [14,18,[20][21][22]24,[26][27][28]. In 62.5% of the studies, only females were included [14,15,[17][18][19]21,23,[25][26][27]. Mean age of the subjects varied between 50.3 years and 79 years [21,22].…”

Regarding

“…3,4 From 2007, we identified LPF as the most appropriate method of reconstruction after vulvoperineal surgery for both primary and recurrence vulvar malignancy.…”

“…In addition, the incidence of complications remains low even when we added the series of 22 women who underwent reconstructive surgery using modified tunneled LPF. 4 When all the 63 operated patients are considered, wound complications occurred only in 9.5% of cases.…”

“…The associated morbidity seems reasonable in particular when a dedicated, skilled multidisciplinary gynecological oncology team is involved. However, a careful preoperative evaluation is critical; tissue type (ie, recurrent cases and previous irradiated cases), size of the loss of substance, technical execution of the pedicle, 4 and the careful attention with which the surgeon handles tissues (eg, adequate control of hemostasis and nonischemic sutures) are the basis for the success of this reconstructive technique.…”