Pudendal Thigh Flap

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Martello JY, Vasconez HC (1995) Vulvar and vaginal reconstruction after surgical treatment for gynecologic cancer, Clin Plast Surg 22:129-40.

McCraw JB, Massey FM, Shanklin KD et al (1976) Vaginal reconstruction with gracilis myocutaneous flaps, Plast Reconstr Surg 58:176-83.

Tobin GR, Day TG (1988) Vaginal and pelvic reconstruction with distally based rectus abdominis and myocutaneous flaps, Plast Reconstr Surg 83:62-73.

Tobin GR, Pursell SH, Day TG Jr (1990) Refinements in vaginal reconstruction using rectus abdominis flaps, Clin Plast Surg 17:705-12.

Wee JT, Joseph VT (1989) A new technique of vaginal reconstruction using neurovascular pudendal thigh flaps. A preliminary report, Plast reconstr Surg 83:701-9.

Semimembranosus Muscle

Figure 5

Underlying anatomy of medial thigh

1 Adductor magnus muscle

2 Adductor longus muscle

3 Sartorius muscle

4 Great sartorius muscle

5 Semitendinosus muscle

6 Gracilis muscle

7 Semimembranosus muscle

Pudendal Flap

Figure 6

Outline of skin island over proximal two-thirds of gracilis muscle

Gracilis Myocutaneous Flap

Figure 7

Skin and cutaneous skin island incised and distal gracilis muscle identified near knee

Pudendal Flap

Figure 8

Myocutaneous flap elevated. Note neurovascular pedicle entering into proximal third of muscle

Pelvic Exenteration

Figure 9

Typical defect in perineum after total pelvic exenteration

Subcutaneous Space Vagina

Figure 10

Myocutaneous flap exteriorized through the introitus

Pudendal Thigh Flap

Figure 11

Bilateral gracilis myocutaneous flaps sewn together

Pudendal Thigh Flap

Figure 12

Bilateral flaps shaped into a pouch

Pudendal Thigh Flap

Figure 13

Neo-vaginal pouch inserted into pelvic space and sutured to the introitus

Pelvic Externation Female Vram Flap

Figure 14

Partial anterior and posterior defect repair

Neurovascular Pedicle Flap Perneum

Figure 15

Skin subcutaneous tissue and deep fascial incision

Pudendal Thigh Fasciocutaneous

Figure 16

Flap elevation

Mastectomy And Muscle Flap

Figure 17

A suture of lateral margins of bilateral flaps to each other

Labium Majus

Figure 18

Skin island on labium majus

Labium Majus

Figure 19

Mobilization of skin island

Pudendal Thigh Flap

Figure 20

Tunnel from vaginal wall to base of myocutaneous flap

Subcutaneous Space Vagina

Figure 21

Closure of labium majus and flap sutured to vaginal mucosa

Five Flap Plasty

Figure 22


Myocutaneous Flap Head

Figure 23

Z-plasty mobilization

Plasty For Reconstruction Vulva
Figure 25

End result

Pudendal Thigh Flap

Figure 26

V-Y procedure

Biceps Femoris Flap

Figure 27

End result

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