Clinical SurgeryV-Y fasciocutaneous flap closure technique is a safe and efficacious alternative to primary closure of the perineal wound following abdominoperineal resection

- Primary closure of perineal defects following abdominoperineal resection is associated with high rates of complications.
- V-Y flap is a means of covering the perineal defect in a tension-free closure.
- Although this study is limited by size, it sets the tone for a potentially beneficial way to close the perineal defect to minimize morbidity.

BackgroundThe aim of this study was to compare wound complications from V-Y flap vs primary closure in the setting of abdominoperineal resection.MethodsThis was a single institution retrospective review (1999-2014). The main outcome measures were any wound complication, hospital length of stay, and unplanned readmissions.ResultsAmong 80 patients included, 21 (26%) received reconstruction with V-Y flap. Compared with those who received primary closure, patients who underwent V-Y flap reconstruction had lower rates of overall wound complications (14.3% vs 64%, P = .002), superficial surgical site infection (6% vs 32%, P = .05), and wound dehiscence (4.5% vs 14%, P = .251 statistical significance not met).ConclusionsReconstruction of perineal defect following abdominoperineal resection using a V-Y fasciocutaneous flap is a safe and efficacious alternative to traditional simple primary closure and is associated with reduced postoperative morbidity. Further comparative effectiveness studies should be undertaken to evaluate long-term and quality-of-life outcomes.