An Algorithmic Anatomical Subunit Approach to Pelvic Wound Reconstruction

Plastic and Reconstructive Surgery
Alexander F MericliChris A Campbell

Abstract

Prior radiation therapy, pelvic dead space, and a dependent location contribute to perineal dehiscence rates as high as 66 percent after primary closure of pelvic wounds. Various regional flaps have been described to reconstruct pelvic defects, but an algorithmic pairing of individual flaps to specific anatomical regions has not been described. A retrospective review of a prospectively maintained database was performed to identify consecutive pelvic reconstructions from 2010 to 2013 with at least 6 months' follow-up. Pelvic defects and resulting flaps were described by anatomical subunits involved: anterolateral thigh flap for mons, gracilis flap for labia majora and introitus, vertical rectus abdominis myocutaneous flap for vagina and/or perineal raphe, and gluteus musculocutaneous flap for isolated perianal defects. Twenty-seven women and three men underwent consecutive pelvic reconstruction with a mean age of 60 years (range, 26 to 83 years) and a mean body mass index of 28 kg/m(2) (range, 17 to 40 kg/m(2)). Twenty-one patients (70 percent) had prior radiation therapy. In total, 45 flaps were performed according to the subunit principle. Three patients had a minor dehiscence (<5 cm), one patient had a major dehiscence, and o...Continue Reading

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Citations

Sep 28, 2017·Plastic and Reconstructive Surgery·Katie E WeichmanJoseph J Disa
Aug 11, 2018·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Alexandra L MartinErin E Medlin
Oct 9, 2019·Plastic and Reconstructive Surgery·Brielle WeinsteinJulian Pribaz
Sep 14, 2016·Plastic and Reconstructive Surgery. Global Open·Don HoangJoseph Carey
Nov 30, 2019·Journal of Surgical Oncology·Gustavo A LaporteWilliam A Casteleins
Jun 17, 2020·Plastic and Reconstructive Surgery. Global Open·Catherine M Westbom, Simon G Talbot
Jul 25, 2019·Plastic and Reconstructive Surgery. Global Open·Lauren E Buchanan, Chris A Campbell
Feb 25, 2021·Obstetrical & Gynecological Survey·Anna PavlovAdeyemi A Ogunleye
Jan 5, 2021·Diseases of the Colon and Rectum·Nishant Ganesh KumarTheodore A Kung
Apr 15, 2021·Journal of Reconstructive Microsurgery·Jhonatan EliaJung-Ju Huang
Jun 12, 2021·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Roberta Alvares AzevedoLuciano A Favorito
Dec 1, 2021·Plastic and Reconstructive Surgery·Christie BialowasAshit Patel

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