Vulvar reconstruction by a “supra-fascial” lotus petal flap after surgery for malignancies

ObjectiveThe aim of this study is to report on our experience with the supra-fascial lotus petal flap following the resection of vulvar cancer.MethodsThe original lotus petal flap or gluteal-fold flap technique was initially described with fascial elevation. However, flap harvesting in a supra-fascial plane is feasible. Between 2008 and 2011, we performed and evaluated this modified flap technique for labia majora reconstruction on five elderly females (mean age: 72 years).ResultsResection and reconstruction were performed in the same operative time with a median time procedure of 118 min. We observed neither flap failure nor partial necrosis. Functional evaluation beyond six months showed low donor site morbidity and good aesthetic results.ConclusionImmediate vulvar reconstruction with supra-fascial lotus petal flap is a fast, easy and reliable procedure. It enables wide resection and safety margin following tumor removal with free tension suture, good aesthetic results and a favourable functional outcome.

► Improve reconstructive surgery after vulvar surgical resection. ► Improve quality of life of women with gynaecological cancer.