V-Y Advancement Flaps for Extensive Perianal Defect Repair

Ibáñez, Noelia; Abrisqueta, Jesús; Luján, Juan; Hernández, Quiteria; Parrilla, Pascual

doi:10.1016/j.cireng.2016.10.006

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…16 Anal stenosis, incontinence and late disturbance in the urinary stream were noticed at follow-up by some authors in up to 30% of patients in cases of mainly perianal defects. 15,17 Age seems to be a factor significantly affecting complication rate (<60 vs >60, odds ratio 0,235, 95% CI 0.073-0.754). 18 Myers et al 16 managed to reduce the complication rate (67% to 37%) by foregoing bolstering with synthetic mesh in cases of perineal wound reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…Larger rotational flaps have been used for larger ment flap has been reported from 14% to 60%. 6,12,15 Wound infection, partial dehiscence, partial flap necrosis and deviation of the urinary stream were the main early complications observed by various authors. Six percent of patients had to be returned to the operating theatre for abscess drainage according to one study.…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of small and moderate defects of the perineum

Ioannidis¹

2022

HJOG

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Introduction: Resection of benign, premalignant or malignant lesions of the perineum result in tissue defects, which are preferably reconstructed with a flap rather than closed primarily or covered with a skin graft. Numerous skin flaps have been utilized with varying success rates. Patients and Methods: The charts of all female patients with perineal defects operated by the author during the past five years were retrospectively reviewed. Two flaps were used: a modified Limberg (rhomboid rotation) flap for small defects and a bilateral medial thigh V-Y advancement flap for moderate defects. Results: Seven patients were found. Two patients were operated because of benign pathology and five because of a pre- or malignant lesion. Two small and five moderate defects resulted after the resection. All flaps survived and there were no major complications. All patients had sensation on the flap postoperatively and were pleased with the functional and aesthetic result. Conclusion: Small perineal defects are satisfactorily restored with a rotation rhomboid flap, whereas moderate sized defects are best reconstructed with bilateral medial thigh V-Y flaps.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reconstruction of small and moderate defects of the perineum

Ioannidis¹

2022

HJOG

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“…Several studies have mentioned that wound dehiscence occurred in 30%–60% of the patients after anoplasty. 2 , 3 In this case, to mitigate tension on the anal wound and prevent contamination, the patient fasted for a week, and wound irrigation was initiated postoperatively. Consequently, the patient experienced no wound dehiscence.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of anal stenosis associated with local flap closure of large perineal defects is highly variable, ranging from 7.7% to 40%. 2 , 3 Treatment options, both nonsurgical and surgical, should be determined based on the severity of the stenosis. 4 Although various corrective techniques are used to widen the anus depending on the surgeon’s experience and the severity of the stricture, there is no universally accepted gold standard.…”

mentioning

confidence: 99%

Bilateral Transposition Flap for Postoperative Anal Stenosis after Reconstruction for Paget Disease

Nakatsuka

Karakawa

Fuse

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Summary: One of the complications of anal surgery or disease is anal stenosis. To release the tension of the anus, a tension-releasing incision in the perianal skin and various anoplasty procedures are usually considered. The aim of this article is to describe a straightforward technique with local flaps for severe anal stenosis after anal reconstruction. A 57-year-old man presented to the clinic with diverticulitis secondary to severe anal stenosis, and reported difficulty with defecation after perianal skin resection around the anus and surgery to create a V-Y advancement flap for perianal primary Paget disease 9 months previously. After improvement of the diverticulitis using antibiotics, bilateral transposition flaps were transferred to release the anal stenosis. The surgical treatment for severe anal stenosis has been known to entail several complications, including infection, incontinence, anal mucosal ectropion, pruritus, wound dehiscence, and restenosis. In this severe case, because the scars were situated at the 6 o’clock and 12 o’clock positions on the anus due to the previous V-Y advancement flap, bilateral rotation flaps were transferred from the 3 o’clock and 9 o’clock positions of the anus to prevent wound dehiscence and partial flap necrosis. Three months later, the size of the anus was unchanged, but additional surgery was performed at the patient’s request. A bilateral transposition flap procedure was used, with flaps designed and elevated from the 6 o’clock and 12 o’clock positions. The postoperative course was uneventful, and the anal stenosis was improved.

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“…12 For perianal defects, VY advancement flaps are an effective and feasible technique to cover them after aggressive surgeries. 13 Reported postoperative morbidities are partial dehiscence, partial flap loss, anal stenosis and incontinence. A literature reported a success in reconstruction of perianal defect using a bilateral VY advancement flap based on the perforating arteries of the gluteus maximus over a cicatricial area.…”

Section: Corresponding Authormentioning

confidence: 99%

Triple VY Advancement Flap For Vulva And Anal Reconstruction In Extensive Perineal Squamous Cell Carcinoma In-Situ

Saphira¹,

Tan²,

Tay³

2018

J Plast Rekons

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Background : Algorithm for vulvar reconstructions in defects after oncologic resection of vulvar tumors has been established. It goals are to restores form and function for the purpose of coitus, micturition, and defecation. The purpose of this article is to present our experience in vulvar and anal reconstruction. Method : A 43-year-old female with extensive vulvar, perineal and anal squamous cell carcinoma in-situ and groin lymph nodes metastasis requiring defect coverage after tumor resection. The defects involving exposed soft tissue around vulvar, perineal and anal areas. Result : Vulvar and anal reconstruction was done in stages utilizing triple VY advancement flap. The reconstruction was successful with preservation of sexual and anal functions; and minimal scarring. Conclution: Extensive vulvar and anal defects can be reconstructed by recruiting local tissue. VY advancement flap is one of the best options in these reconstructions.

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V-Y Advancement Flaps for Extensive Perianal Defect Repair

Cited by 4 publications

References 18 publications

Reconstruction of small and moderate defects of the perineum

Reconstruction of small and moderate defects of the perineum

Bilateral Transposition Flap for Postoperative Anal Stenosis after Reconstruction for Paget Disease

Triple VY Advancement Flap For Vulva And Anal Reconstruction In Extensive Perineal Squamous Cell Carcinoma In-Situ

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