The superficial external pudendal artery (SEPA) axial-pattern flap

Dias, A.D.

doi:10.1016/0007-1226(84)90020-1

Cited by 21 publications

(5 citation statements)

References 2 publications

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“…However, IPAP flap and SEPAP flaps were chosen as workhorse flaps in the current study. These two flaps are not novel, and their utility for reconstruction of perineal defect has been much reported (Brousse et al, 2019;Dias, 1984;Dias et al, 1987;Han et al, 2018;Hashimoto et al, 2014;Phoon et al, 2014). They are common in that their source perforators are Potential strength of this algorithm could be found in its relative simplicity and versatility.…”

Section: Discussionmentioning

confidence: 99%

Penoscrotal defect reconstruction using loco‐regional flaps in treatment of extramammary Paget's disease: Experience and suggestion of a simplified algorithm

Kim

Sung

et al. 2022

Microsurgery

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Background: Reconstruction of penoscrotal defects resulted from margin-controlled excision of extramammary Paget's disease (EMPD) remains challenging, due to its unpredictably varying extents. The present study aimed to investigate outcomes of reconstruction of penoscrotal defects following radical excision of EMPD and to introduce a simplified algorithm for selecting reconstruction strategies.Methods: Patients with penoscrotal EMPD who were treated with wide excision and subsequent reconstruction from 2009 to 2020 were reviewed. Their demographics, operation-related characteristics, and postoperative outcomes were evaluated.Results: In total, 46 patients with a mean age of 64.9 years (range, 44-85 years) were analyzed. An average size of defects was 129.6 cm 2 (range, 8-900 cm 2 ). The most frequently involving anatomical subunit was scrotum, followed by suprapubic area and penile shaft. Twenty-six patients had defects spanning multiple subunits. The most commonly used reconstruction methods for each anatomical subunit were internal pudendal artery perforator (IPAP) flaps and/or scrotal flaps for scrotal defects, superficial external pudendal artery perforator (SEPAP) flaps for suprapubic defects, and skin grafts for penile defects. In all but four cases, successful reconstruction was achieved with combination of those reconstruction options. No major complications developed except for one case of marginal flap necrosis. All patients were satisfied with their aesthetic and functional results.Conclusions: Diverse penoscrotal defects following excision of EMPD could be solidly reconstructed with combination of several loco-regional options. A simplified algorithm using in combination of IPAP flap, SEPAP flap, scrotal flap, and skin graft may enable efficient and reliable reconstruction of penoscrotal EMPD defects. | INTRODUCTIONExtramammary Paget's disease (EMPD) is a rare, slow-growing intraepithelial adenocarcinoma localized to areas of apocrine gland distribution outside the mammary glands. It occurs most frequently in the external genitalia of women and less frequently in the external genitalia of men, perianal area, and axillary area. Clinically, EMPD manifests as an erythematous, eczematoid, and well-demarcated lesion with symptoms of pruritis and pain (Lloyd & Flanagan, 2000;

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Section: Discussionmentioning

confidence: 99%

Penoscrotal defect reconstruction using loco‐regional flaps in treatment of extramammary Paget's disease: Experience and suggestion of a simplified algorithm

Kim

Sung

et al. 2022

Microsurgery

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“…The puboinguinal flap is a hair-bearing flap raised from the medial groin area to the symphysis pubis, and it receives most of its nutrition from the external pudendal artery (EPA). Dias 8 and Patil et al 9 reported the use of a superficial external pudendal artery flap as a pedicle flap, but we have employed this flap as a free skin flap. The skin territory of the inguinal side coincides with the skin territory of the groin flap fed by the superficial epigastric artery (SEA) and/or superficial circumflex iliac artery (SCIA).…”

Section: Discussionmentioning

confidence: 99%

“…Dias 8 and Patil et al 9 investigated the diameters of the EPA and its corresponding vein (EPV) in 12 cases. 89 Although their studies were not statistically validated, they found that the diameter of the superficial EPA at the point where it branches off from the femoral artery was 2 mm, while the diameter of the superficial EPV was also large.…”

Section: Discussionmentioning

confidence: 99%

Beard Restoration Using a Free Puboinguinal Hair‐Bearing Flap

Sasaki¹,

Nozaki²,

Katahira³

1998

J reconstr Microsurg

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“…All three vessels radiate out from the saphenous opening and give off branches which are mostly arranged radially, like the spokes of a wheel, centred on the saphenous opening. [8,9,10] As the SEPA had remained unexploited, the present study was undertaken to ascertain its potential use in the closure of adult exstrophy and epispadias repair on either side of the midline, extending from the symphysis pubis to the umbilicus, designing the defect. Accurate knowledge of the anatomy of the vessel concerned is a prerequisite for skin flap (Figure 2).…”

Section: A B D O M I N a L W A L L D E Fe C T Smentioning

confidence: 99%

SEPA Based Flap for Covering Defect after Adult Exstrophy Epispadias Repair

Bolbandi¹,

Raghuveer

Agarwal

2022

jemds

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INTRODUCTION Bladder exstrophy is a complex, rare disorder that affects the foetus in utero. Here the abdominal wall is not fully formed, leaving the pubic bones separated and the bladder exposed in the lower abdominal wall. METHODOLOGY Single-stage reconstructive and repair surgery was undertaken in adults diagnosed with bladder exstrophy epispadias complex. The superficial external pudendal artery flap was considered for covering the defect after extensive reviews and discussion. CONCLUSION An uneventful surgery with recovery and a two-year follow-up post-surgery did not account for any complications following the procedure. This shows that the superficial external pudendal artery flap can be considered a favourable option for urologists in the repair of bladder exstrophy epispadias complex when undertaken in a single sitting surgery, especially in adults. MeSH Terms Bladder Exstrophy, epispadias repair, superficial external pudendal artery, axial-pattern flap.

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The superficial external pudendal artery (SEPA) axial-pattern flap

Cited by 21 publications

References 2 publications

Penoscrotal defect reconstruction using loco‐regional flaps in treatment of extramammary Paget's disease: Experience and suggestion of a simplified algorithm

Penoscrotal defect reconstruction using loco‐regional flaps in treatment of extramammary Paget's disease: Experience and suggestion of a simplified algorithm

Beard Restoration Using a Free Puboinguinal Hair‐Bearing Flap

SEPA Based Flap for Covering Defect after Adult Exstrophy Epispadias Repair

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