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Case Reports
. 2018 Aug 24:26:24-28.
doi: 10.1016/j.gore.2018.08.007. eCollection 2018 Nov.

Utilizing V-Y fasciocutaneous advancement flaps for vulvar reconstruction

Lauren C Hand  1 , Talia M Maas  1 , Nadia Baka  2 , Rebecca J Mercier  1 , Patrick J Greaney  3 , Norman G Rosenblum  1   4 , Christine H Kim  1   4
Affiliations
Case Reports

Utilizing V-Y fasciocutaneous advancement flaps for vulvar reconstruction

Lauren C Hand et al. Gynecol Oncol Rep. .

Abstract

Objectives: We aimed to analyze the outcomes of patients who underwent vulvectomy with subsequent V-Y fasciocutaneous flap reconstruction.

Methods: All medical records of all patients who underwent vulvectomies with V-Y fasciocutaneous flap reconstruction from January 2007 to June 2016 were retrospectively reviewed. Patient clinical and surgical data, demographics, and outcomes were abstracted.

Results: Of the 27 patients, 42 flaps were transferred. A simple vulvectomy was performed in 8 (30%) patients, partial radical vulvectomy in 15 (56%), and radical vulvectomy in 4 (15%). The median area of defect was 30 cm2. Minor wound separations occurred in 9 patients (33%). Infectious complications occurred in 4 patients (15%); this included urinary tract infections in 2 (50%), postoperative fevers in 2 (50%), and sepsis in 1 (25%) patient with a UTI. There were no instances of flap necrosis, wound dehiscence, or wound infections. Black race was more likely to be associated with an infectious complication with 3 (75%) patients, compared to white race with 1 (4%) patient (p < .01). The presence of diabetes was more likely to be associated with an infectious complication in 2 (67%) patients, compared to 1 (4%) in non-diabetic patients (p < .01). No other significant association was found during analysis of demographics, medical comorbidities, vulvar pathology, or surgical factors affecting V-Y fasciocutaneous flap infectious complications or minor wound separations.

Conclusions: The use of a V-Y fasciocutaneous advancement flap for vulvar reconstruction is safe and associated with mostly minor complications. Infectious complications were more frequently associated with diabetes, black race, and HIV.

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Figures

Fig. 1
Fig. 1
Creation of V—Y Fasciocutaneous Flap. A. Initial defect in blue. B. Initial V-shaped skin incision is made adjacent to the defect. Subcutaneous tissue underlying V is undermined. C. V-shaped skin is mobilized over the primary vulvar defect, is mobilized and medial edge closed. D. Apex of the V is closed linearly. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
Fig. 2
Fig. 2
Radical vulvectomy with bilateral V—Y Fasciocutaneous Advancement Flaps. Initial defect prior to surgical intervention. After resection of the lesion with marked flaps to be excised. Final appearance of bilateral flaps in place.
See this image and copyright information in PMC

References

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