Perforator Flaps for Perineal Reconstructions

ABSTRACT

Whenever there is soft tissue loss from the perineum there are many options for reconstruction. These include allowing the wound to heal by secondary intention and the use of local random or axial pattern flaps, regional flaps, or free flaps. The axial skin flap can be defined as a flap based on known constant vessels of the subcutaneous tissue and its vena comitantes. The perforator flap on the other hand is a randomly selected perforator consisting of an artery with vena comitantes, which perforate the deep fascia to supply the subcutaneous vascular networks. The perineum has a rich blood supply with multiple perforating vessels, and the vascular network of the perineum is similar to that of the head and neck. Anatomically, there exist circles of anastomosis around any orifice or joint. The perineum has two outlets: the urogenital and the anal. The arterial network of the perineum is supplied by the vessels of the lower abdomen, medial thigh, and gluteal region. Knowledge of the rich blood supply of the perineum can be applied to harvest the various types of perforator flaps in perineal reconstruction.

KEYWORDS

Skin flap - perforator flaps - perineal reconstruction

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SUGGESTED READINGS

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