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Paraumbilical perforator flap for one-stage reconstruction of a large oncologic vulvar defect: a single case report

  • Chao Lian1
  • Xue-Lei Li1,*,
  • Xiao-Jun Liu2,*,

1Department of Plastic and Reconstructive Surgery, Changzhi People’s Hospital, Shanxi Medical University, 046000 Changzhi, Shanxi, China

2Department of Plastic and Reconstructive Surgery, Nanfang Hospital, Southern Medical University, 510515 Guangzhou, Guangdong, China

DOI: 10.31083/j.ejgo4206190 Vol.42,Issue 6,December 2021 pp.1316-1319

Submitted: 17 February 2021 Accepted: 07 April 2021

Published: 15 December 2021

*Corresponding Author(s): Xue-Lei Li E-mail: czsrmyylxl@126.com
*Corresponding Author(s): Xiao-Jun Liu E-mail: lxjun_ok@126.com.com

Abstract

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 30 and recurrent vulvar squamous cell carcinoma, without comorbidities involving hypertension and diabetes 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 ×× 8 cm22 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. Follow-up 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.

Keywords

Paraumbilical perforator flap; Vulvar cancer; One-stage reconstruction


Cite and Share

Chao Lian,Xue-Lei Li,Xiao-Jun Liu. Paraumbilical perforator flap for one-stage reconstruction of a large oncologic vulvar defect: a single case report. European Journal of Gynaecological Oncology. 2021. 42(6);1316-1319.

References

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