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Modified Gluteal Fold V-Y Advancement Flap for Vulvovaginal Reconstruction

Lee, Jung Ho MD*; Shin, Jong Weon MD*; Kim, Sang Wha MD*; Oh, Deuk Young MD*; Park, Jong Sup MD, PhD; Hur, Soo Young MD, PhD; Rhie, Jong Won MD, PhD*; Ahn, Sang Tae MD, PhD*

doi: 10.1097/SAP.0b013e31824f23e4
Reconstructive Surgery
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The gluteal fold V-Y advancement flap is a good option for the reconstruction of a vulvovaginal defect because it is thin, sensate, reliable, and has matched local skin quality. However, in situations where wider and deeper vulvovaginal reconstruction is needed, advancement of the flap alone may not be sufficient to create tension-free closure. To overcome these limitations, we designed a modified gluteal V-Y advancement flap, which has 1 or 2 additional transposition flaps at the base of the conventional advancement flap.

This study includes a total number of 16 patients who had received vulvovaginal reconstruction with our new technique between March 2008 and April 2011. The causes of the defects were vulvar cancer in 13 patients and extramammary Paget disease in 3 patients. We examined the location and size of the defect, the flap design, and postoperative clinical courses. The mean follow-up period was 10.6 months, and the defect sizes ranged from 8 × 6 to 15 × 12 cm2. Overall, 11 of 16 patients were reconstructed with bilateral modified gluteal fold V-Y advancement flaps, and 5 patients were treated with a unilateral flap. All flaps survived without major complications, and the aesthetic and functional results were satisfactory. The modified gluteal fold V-Y advancement flap is useful and reliable for the reconstruction of wide and deep vulvovaginal defects. It can cover the defect without tension, and the complications associated with it are rare.

From the *Department of Plastic and Reconstructive Surgery and †Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Received November 8, 2011, and accepted for publication, after revision, February 7, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Jong Won Rhie, MD, PhD, Department of Plastic and Reconstructive Surgery, Seoul St. Mary’s Hospital, 505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea. E-mail: rhie@catholic.ac.kr.

© 2013 by Lippincott Williams & Wilkins