'Perineal keystone design perforator island flap' for perineal and vulval reconstruction

摘要

Vulval cancer represents 3-5% of all gynaecological malignancies, with wide resections requiring consideration of reconstructive options. A variety of local flaps have been described in this setting, many of which are based on perforators of the internal pudendal artery: the pudendal thigh flap, Singapore flap, lotus leaf flap and gluteal fold flap. A limitation of these flaps is the specific design needed with which to include the necessary internal pudendal perforators. The keystone design perforator island flap (KPIF) is a technique we have used in many body regions, which can be used to safely capture the required perforator base, without the need to identify specific perforators in either flap planning or intraopera-tively. We thus describe the perineal KPIF.