Stepladder V–Y advancement medial thigh flap for the reconstruction of vulvoperineal region

SummaryMany surgical procedures have been reported for vulvoperineal reconstruction following cancer resection. These include the use of skin grafts, local skin flaps, muscle flaps and fasciocutaneous flaps. Among them, V–Y advancement flap from the medial thigh region has been widely used. However, at times a scar contracture occurs, caused by the long, straight suture line. From September to October 2007, we performed vulvoperineal reconstruction following cancer resection using stepladder V–Y advancement medial thigh flaps in three patients. All flaps survived completely and no scar contracture was observed in all the patients. No surgical revisions were needed. This flap is reliable, easy to be elevated and allows immediate repair of deep defects. This technique can be useful for the reconstruction of the vulvoperinela region because zigzag scars are inconspicuous, diminish the postoperative scar contracture and achieve normal urination.