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Novel treatment (new drug/intervention; established drug/procedure in new situation)
Vulva reconstruction after pelvic exenteration, using a unique combination of two flaps
  1. Annelotte C M van Bommel1,
  2. Henk W R Schreuder2,
  3. Pascal P A Schellekens1
  1. 1Department of Plastic and Reconstructive Surgery, University Medical Centre, Utrecht, Netherlands
  2. 2Department of Gynecologic Oncology, University Medical Centre, Utrecht, Netherlands
  1. Correspondence to Dr Henk W R Schreuder, h.w.r.schreuder{at}umcutrecht.nl

Summary

A 64-year-old woman with recurrence of carcinoma of the vulva in an irradiated area received an en-bloc total pelvic exenteration. Reconstruction of the pelvic defect was performed with an anterolateral thigh (ALT) flap and a rectus abdominis muscle (RAM) flap (PM/RAM). This combination of flaps is unique, with excellent results.

In a large defect, often irradiated in advance, well-vascularised tissue should be placed. Multiple flaps can be used to reconstruct these large pelvic defects, each with their own advantages and disadvantages.

The combination of flaps used in this case uses the good properties of both flaps: the reliable and well-vascularised PM/RAM in combination with the ALT flap to provide much bulk in extreme large defects.

https://doi.org/10.1136/bcr.01.2011.3717

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    Footnotes

    • Competing interests None.

    • Patient consent Obtained.