+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Radical excision of vulval disease and multidisciplinary tissue flap reconstruction: the belfast experience

Radical excision of vulval disease and multidisciplinary tissue flap reconstruction: the belfast experience

International Journal of Gynecological Cancer 22(2): 323-327

The aim of this study was to compare Belfast City Hospital's vulval flap reconstructive surgery with recognized standards and published data to facilitate modifications to practice. Retrospective cohort study involving women who underwent vulval reconstructive skin flap procedures from January 1, 2004, through December 31, 2009. A total of 25 women underwent 28 flaps; age range was 41 to 90 years and mean parity was 2.1. Indications for surgery were recurrence of cancer in 11 (44%) of the 25 women, benign disease in 6 women (24.0%), primary vulval cancer in another 6 women (24.0%), and vulval intraepithelial neoplasia in 2 women. Thirteen women (52.0%) within the study had undergone previous radical vulval excision. Wide local excision was performed in 14 women (56.0%), with 5 undergoing radical vulvectomy and 6 undergoing modified radical vulvectomy. There were 15 (53.6%) of the 28 lotus flaps, 6 (21.4%) rhomboid-type repairs, and 3 (10.7%) gracilus flaps.Intensive care unit admission immediately after operation was required in 2 (8.0%) of the 25 women. Return to the operating theater was required in 5 cases (20.0%). Hospital stay ranged from less than 1 week to greater than 6 weeks, the mode being 8 to 14 days and mean being 21.5 days. A total of 16 (64.0%) of the 25 cases experienced wound infection with or without breakdown, with 12 cases (48.0%) having wound infection. There were 10 cases (40.0%) of partial or complete wound breakdown. Necrosis of wound (5 cases) and lymphocyst (2 cases) were less common. Twelve women (48.0%) experienced some form of medical postoperative complication(s), whereas 15 women (60.0%) had no long-term complications. The rate of local flap procedure is higher than that published elsewhere, whereas the postoperative complication rate is comparable and adherent to accepted standards. Perioperative protocols have been reported to improve complication rates, and this strategy has been adopted in Belfast.

(PDF emailed within 0-6 h: $19.90)

Accession: 055345840

Download citation: RISBibTeXText

PMID: 22080881

DOI: 10.1097/IGC.0b013e318232c4be

Related references

The anterolateral thigh (ALT) flap in reconstruction following radical excision of groin and vulval hidradenitis suppurativa. Journal of Plastic, Reconstructive & Aesthetic Surgery 60(12): 1363-1365, 2007

Vulval reconstruction after cancer excision the island groin flap technique. British Journal Of Plastic Surgery. 43(2): 159-161, 1990

Radical subcutaneous excision and flap reconstruction for genital lymphedema. Journal of Urology 151(5 SUPPL ): 437A, 1994

The results of radical excision of oral and oropharyngeal cancer requiring pedicle flap reconstruction. Australian and New Zealand Journal of Surgery 42(2): 148-151, 1972

Extended wrap-around flap for thumb reconstruction following radical excision of a congenital arteriovenous fistula. Journal of Hand Surgery 23(1): 72-75, 1998

Treatment of pilonidal sinus by radical excision and reconstruction by rotation flap surgery or z plasty technique. Scandinavian Journal of Plastic & Reconstructive Surgery 13(2): 351-353, 1979

The gluteal fold fascio-cutaneous flap for reconstruction after radical excision of primary vulvar cancers. Gynecologic Oncology 113(2): 245-248, 2009

Vulval reconstruction using rectus abdominis musculocutaneous flap transfer with secondary liposuction in extramammary Paget's disease. Annals of Plastic Surgery 38(2): 179-183, 1997

Elliptical excision with midline primary closure versus rhomboid excision with limberg flap reconstruction in sacrococcygeal pilonidal disease: a prospective, randomized study. Indian Journal of Surgery 74(4): 305-308, 2013

The "kite" flap in the reconstruction after excision of a basal cell carcinoma of the face. Our experience with 45 cases. Revue de Stomatologie et de Chirurgie Maxillo-Faciale 90(5): 345-348, 1989

The infrahyoid musculocutaneous flap: experience of 153 cases in the reconstruction of the oropharynx and oral cavity after tumoral excision. Revue de Laryngologie - Otologie - Rhinologie 125(1): 49-53, 2004

The radial forearm free flap in oro-maxillo-facial reconstruction. Experience of a multidisciplinary team approach--maxillofacial and plastic surgery. Chirurgia 102(3): 319-325, 2007

A new approach to reconstruction following vulval excision. British Journal of Obstetrics and Gynaecology 103(5): 475-477, 1996

What Is the Ideal Free Flap for Soft Tissue Reconstruction? A Ten-Year Experience of Microsurgical Reconstruction Using 334 Latissimus Dorsi Flaps From a Universal Donor Site. Annals of Plastic Surgery 75(1): 49-54, 2016