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Comparison of inferior gluteal artery perforator flaps versus vertical rectus abdominis musculocutaneous flaps in the reconstruction of perineal wounds.
Benedict, Katherine C; Songcharoen, Somjade J; Stephens, Kristin L; Winter, Anna L; Edwards, Shelley R; Campbell, Christopher A; Arnold, Peter B.
Afiliación
  • Benedict KC; University of Mississippi Medical Center, Division of Plastic and Reconstructive Surgery, 2500 North State Street, Jackson, MS 39216, USA. Electronic address: kbenedict@umc.edu.
  • Songcharoen SJ; University of Mississippi Medical Center, Division of Plastic and Reconstructive Surgery, 2500 North State Street, Jackson, MS 39216, USA.
  • Stephens KL; University of Virginia, Department of Plastic Surgery, 200 Jeanette Lancaster Way, Charlottesville, VA 22903, USA.
  • Winter AL; University of Mississippi Medical Center, Division of Plastic and Reconstructive Surgery, 2500 North State Street, Jackson, MS 39216, USA.
  • Edwards SR; University of Mississippi Medical Center, Division of Plastic and Reconstructive Surgery, 2500 North State Street, Jackson, MS 39216, USA.
  • Campbell CA; University of Virginia, Department of Plastic Surgery, 200 Jeanette Lancaster Way, Charlottesville, VA 22903, USA.
  • Arnold PB; University of Mississippi Medical Center, Division of Plastic and Reconstructive Surgery, 2500 North State Street, Jackson, MS 39216, USA.
J Plast Reconstr Aesthet Surg ; 84: 514-520, 2023 09.
Article en En | MEDLINE | ID: mdl-37418850
BACKGROUND: Achieving a healed perineal wound following chemoradiotherapy and abdominoperineal resection (APR) is challenging for surgeons and patients. Prior studies have shown trunk-based flaps, including vertical rectus abdominis myocutaneous (VRAM) flaps, are superior to both primary closure and thigh-based flaps; however, there has been no direct comparison with gluteal fasciocutaneous flaps. This study evaluates postoperative complications after various methods of perineal flap closure of APR and pelvic exenteration defects. METHODS: Retrospective review of patients who underwent APR or pelvic exenteration from April 2008 through September 2020 was analyzed for postoperative complications. Flap closure techniques, including VRAM, unilateral (IGAP), and bilateral (BIGAP) inferior gluteal artery perforator fasciocutaneous flaps, were compared. RESULTS: Of 116 patients included, the majority underwent fasciocutaneous (BIGAP/IGAP) flap reconstruction (n = 69, 59.6%), followed by VRAM (n = 47, 40.5%). There were no significant differences between group patient demographics, comorbidities, body mass index, or cancer stage. There were no significant differences between BIGAP/IGAP and VRAM groups in minor complications (57% versus 49%, p = 0.426) or major complications (45% versus 36%, p = 0.351), including major/minor perineal wounds. CONCLUSIONS: Prior studies have shown flap closure is preferable to primary closure after APR and neoadjuvant radiation but lack consensus on which flap offers superior postoperative morbidity. This study comparing outcomes of perineal flap closure showed no significant difference in postoperative complications. Fasciocutaneous flaps are a viable choice for the reconstruction of these challenging defects.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Recto / Colgajo Perforante / Colgajo Miocutáneo Tipo de estudio: Etiology_studies / Observational_studies Límite: Humans Idioma: En Revista: J Plast Reconstr Aesthet Surg Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Recto / Colgajo Perforante / Colgajo Miocutáneo Tipo de estudio: Etiology_studies / Observational_studies Límite: Humans Idioma: En Revista: J Plast Reconstr Aesthet Surg Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos