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Summary
Background: Large vulvar defects often results in complex reconstructive problems. Deep inferior epigastric perforator (DIEP) flap was considered as a less invasive and reliable method for vulvar reconstruction. However, tedious dissection of the pedicle vessel requires a longer flap harvesting time. To overcome the disadvantage, paraumbilical perforator (PUP) flap was developed with the perforator only penetrating the retus abdominis muscle. However, no case has previously been reported of using PUP flap for vulvar reconstruction. In our report, we are first writing to share our own clinical experience of using PUP flap as an aid to cover a large vulvar defect. Case: We present a case of a 60-year-old female with a BMI of 3o and recurrent vulvar squamous cell carcinoma, without comorbidities involving hypertension anddiabetes mellitus. By the aid of a Doppler probe, PUP was identified and labeled on the skin. A radical vulvectomy without additional treatment (chemotherapy and/or radiotherapy) was subsequently underwent, with a final defect consisting of a campaniform, full-thickness skin defect measuring 15 x 8 cm(2) without involvement of the urethra and vagina. By the aid of a PUP flap, the large defect was successfully reconstructed in one stage. The duration of surgery is nearly 3 hours. Postoperative management consists of remained urinary catheterization and complete bed rest. Followup was respectively performed at 3, 6 months. No local recurrence or distant metastasis was found. Conclusions: Our results suggest that PUP flap has shown to be an alternative and new method for one-stage reconstruction of vulvar defects. Further investigations for this novel flap to treat such cases are needed.
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Institution南方医科大学
