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The interrupted V-Y advancement flap for the reconstruction of the vulvovaginal defect

Authors

  • Yoshiaki Sakamoto MD,

    Corresponding author
    • Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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  • Hideo Nakajima MD,

    1. Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
    2. Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
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  • Nobuaki Imanishi MD,

    1. Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
    2. Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
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  • Kazuo Kishi MD

    1. Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
    2. Department of Anatomy, Keio University School of Medicine, Tokyo, Japan
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  • Conflict of interest: None declared

Correspondence

Yoshiaki Sakamoto, md

Department of Plastic and Reconstructive Surgery

Keio University School of Medicine

35 Shinanomachi

Shinjuku-ward

Tokyo 160-8582

Japan

E-mail: ysakamoto@z8.keio.jp

Abstract

Background

High-quality reconstruction of vulvovaginal defects after tumor excision is critical. Various techniques for vulvovaginal reconstruction have been described. However, these flaps are often bulky, and tip necrosis occasionally occurs. To reduce bulkiness and prevent flap necrosis, we have therefore developed an ideal approach using a fasciocutaneous flap that is advanced in a modified V-Y fashion.

Materials and methods

The V-Y flap is interrupted in the defect area by a bipedicled flap and therefore termed “the interrupted V-Y advancement flap”.

Results

We used the interrupted V-Y advancement flap to cover vulvovaginal defects in five patients who underwent surgical treatment for extramammary Paget's disease or carcinoma of the vulva. Each flap survived completely without complications.

Conclusions

This flap is easily elevated, not bulky, and reliable because it is supplied by the internal pudendal artery and vein without excessive skeletonization of the vascular pedicle; it also matches the local skin quality.

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