Pedicled vertical posteromedial thigh (vPMT) flap for the reconstruction of extensive perianal-genital defects

Wishart, Katarina; Fritsche, Elmar; Scaglioni, Mario F.

doi:10.1016/j.bjps.2020.08.001

Cited by 8 publications

(8 citation statements)

References 32 publications

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“…In any manner, disparate flaps were still feasible. The main ones were anterolateral thigh (ALT) flap, deep inferior epigastric perforator (DIEP) flap, and vertical posteromedial thigh (vPMT) flap (Hashimoto et al, 2014; Seyhan & Borman, 2008; Wishart et al, 2021; Xu & Watt, 2018). Nevertheless, despite their well‐validated efficacy for many different reconstructions, all of them present major drawbacks in this particular setting.…”

Section: Discussionmentioning

confidence: 99%

Pedicled superficial circumflex iliac artery perforator flap for male genital reconstruction: A case series

2022

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Background: Different issues may cause defects in the genital region, including urological, infective, oncological and genetic problems which often lead to significant defects. This is a very delicate region and a successful coverage requires a thin, pliable and reliable solution. In this setting the SCIP flap might be an outstanding procedure. Despite being a well-known solution in the groin region, its employment for genital reconstructions is still poorly described. For this reason, we gather our experience with this procedure showing the efficacy of the SCIP flap in this specific region.Patients and Methods: In the present case series we included 6 male patients who received a soft tissue defect reconstruction by means of pedicled SCIP flap over the last year. The average age was 53.6 years old (range 34-79 years). Among them, 5 patients received a surgical excision because of severe acne (2 cases), Fournier's gangrene (2 cases), or scrotal squamous cell carcinoma (1 case). In 1 case the cause of the missing volume was testicle agenesis and the reconstruction was performed for cosmetic purposes. Size of the defects ranged from 7 cm Â 4 cm to 20 cm Â 6 cm. Elliptical shaped flaps were designed either mono-or bilaterally according to the need. All the flaps were supplied by the superficial branch of the SCIA. The range of rotation varied between 150 and 180 in order to reach the affected area. Results:The flaps' dimension ranged from 8 cm Â 4 cm to 20 cm Â 6 cm. All the patients were successfully treated. In 1 case we encountered a small wound dehiscence, which was managed conservatively. The mean follow-up was 9.5 months (range 6-12 months). Good cosmetic result was achieved in all cases and no urinary or sexual dysfunctions were reported. Conclusions:The pedicle SCIP flap represents a reliable solution for genital and inguinal defects reconstructions. Its versatility can be exploited throughout the region providing very good quality tissues that can be used for the most disparate situations. | INTRODUCTIONSoft tissue defects in the genital area represent a delicate and critical issue that plastic surgeons may encounter rather often during their practice. The underlying causes may be heterogeneous ranging from trauma, to infection, to congenital problems, such as in case of testicle agenesis (Garaffa et al., 2011;Rosevear et al., 2009). Other common examples that require a genital soft tissue resection are tumors (Bickell et al., 2016), Fournier's gangrene (Lee et al., 2007, extramammary Paget's disease (Lee et al., 2007), and unfortunately Mario F. Scaglioni and Matteo should be considered first co-authors.

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Section: Discussionmentioning

confidence: 99%

Pedicled superficial circumflex iliac artery perforator flap for male genital reconstruction: A case series

2022

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“…In addition, we should involve more medical research and related personnel, and formulate appropriate early prevention and intervention measures. The potential impact of culturally speci c social cognitive processing styles on the burden of UCAs remains uncertain and requires further investigation [23,24].…”

Section: Discussionmentioning

confidence: 99%

Gender difference in the burden of urogenital congenital anomalies at global, regional, and national levels from 1990 to 2019: results from the Global Burden of Disease Study 2021

Huang

Tang

Chen

et al. 2022

Preprint

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Aims. Urogenital congenital anomalies(UCAs) involve both urinary tract and/or genital tract congenital malformations, which may cause severe neonatal death. This research aimed to reveal the latest magnitudes and temporal trends of geographical distribution for UCA burden and their gender difference to help develop more detailed prevention and intervention policies. Methods. The data for the disease burden of UCAs from 1990 to 2019 was exacted from the Global Burden of Disease Study 2019. The average annual percentage change was calculated to quantify the secular trends in age-standardized rates (ASRs) of UCA burden. Meanwhile, a cross-sectional comparison of the disease burden was made at the time points of 1990 and 2019. Results. In 2019, there were an estimated 1.13×106 [95% uncertainty interval (UI) 0.795-1.62] incident cases of UCA, 6.28×106 [95% UI 4.98-7.72] prevalent cases and 1.09×106 [95% UI 0.832-1.41] disabilityadjusted life years(DALYs) globally. For female UCAs, there were an estimated 0.559×106 [95% UI 0.392-0.790] incident cases, 3.17×106 [95% UI 2.53-3.88] prevalent cases and 0.438×106 [95% UI 0.302-0.604] DALYs. For male UCAs, there were an estimated 0.576×106 [95% UI 0.405-0.833] incident cases, 3.11×106 [95% UI 2.45-3.83] prevalent cases and 0.657×106 [95% UI 0.435- 0.925] DALYs. Conclusions. Our analysis confirms that UCAs are an underestimated public children's health concern. There was a slight upward trend of prevalence and incidence rates for UCAs, whereas the deaths rate and DALYs rates both showed relatively decreasing trends over the past 30 years globally. These substantial heterogeneities in the UCA burden worldwide and giant differences in the female and male cases highlight the need to detect the potentially influential factors for the UCA and devise suitable policies and provide specific clinical research.

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“…The operation was performed in the same way as previously described by Scaglioni et al (Chen et al, 2015; Scaglioni et al, 2015; Scaglioni et al, 2018; Wishart et al, 2020a, 2020b) The authors added their own methods in this big frame. The surgery was performed in a lithotomy position under general anesthesia.…”

Section: Methodsmentioning

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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Pedicled vertical posteromedial thigh (vPMT) flap for the reconstruction of extensive perianal-genital defects

Cited by 8 publications

References 32 publications

Pedicled superficial circumflex iliac artery perforator flap for male genital reconstruction: A case series

Pedicled superficial circumflex iliac artery perforator flap for male genital reconstruction: A case series

Gender difference in the burden of urogenital congenital anomalies at global, regional, and national levels from 1990 to 2019: results from the Global Burden of Disease Study 2021

Propeller posteromedial thigh perforator flaps for coverage of extensive perineal defects

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