What is it about?
We present the case of a 47-year-old woman with a perianal Paget’s disease who underwent surgical excision of the lesion. The reconstructive technique was a pedicle flap based on an internal pudental skin perforator artery. The flap was designed in a diamond-shaped pattern.
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Why is it important?
A polygonal diamond-shaped flap is an easy and reliable choice for perineal reconstruction offering better adjacement in the perianal region and avoidance of the curvilinear perianal incision (which often leads to anal stenosis).
Perspectives
Reconstruction of perineal defects is a challenging procedure. Various surgical techniques have been proposed. Compared to traditional myocutaneous flaps, pedicled perforator flaps are believed to be a less invasive option for perineal reconstruction with better functional and cosmetic results.A modified V-Y technique, the flap in a diamond-shaped pattern for perineal reconstruction based on internal pudental artery or other adjacent arteries, such as perineal, obturator or inferior gluteal artery, is a safe, efficient method that provides maintenance of maximal blood supply to the flap, minimal tension to the suture lines, and allows primary closure of the donor site. The Diamond perforator flap is a simple, modern surgical concept which minimizes local complications (flap necrosis), is easy to apply to the perianal region and is not associated with anal stenosis. This flap is a modification of V-Y flap, since the typical V-Y flap would cause anal stenosis and could not be applied beyond the sphincter.
Dr Parthena Deskoulidi
Saint Savvas Cancer Hospital of Athens-Greece
Read the Original
This page is a summary of: Perineal Reconstruction with a Diamond-shaped Perforator Flap: A Case Report, Plastic and Reconstructive Surgery Global Open, March 2018, Wolters Kluwer Health,
DOI: 10.1097/gox.0000000000001697.
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