Vulvar reconstruction using the "lotus petal" fascio-cutaneous flap

Peter A. Argenta, Rhona Lindsay, R. Benjamin Aldridge, Nadeem Siddiqui, Kevin Burton, John R.C. Telfer

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Introduction Vulvar reconstruction using the "lotus petal" fascio-cutaneous flap offers a relatively novel means to restore symmetry and functionality after extirpative gynecologic or oncologic procedures. We sought to assess the success rates and morbidity in a large series of consecutively treated patients. Methods We performed a retrospective review of 59 consecutive cases of lotus petal flaps performed at a single institution to more accurately assess success and complication rates. Results We identified 80 flaps performed among the 59 patients between September 1, 2008 and March 30, 2013. The median (range) age was 59 years (24-89) and the median (range) BMI was 27 kg/m 2 (19-34). The indications for vulvar/perineal excision were as follows: 39 (66.1%) vulvar carcinoma or melanoma, 12 (20.3%) vulvar dysplasia, 5 (8.5%) colorectal disease and 3 (5.1%) cases of hidradenitis suppurativa. The mean defect area, determined by post-fixation pathology specimen was 29 cm 2. Medical or surgical complications occurred in 36% of patients of which superficial wound separation was the most common (15%). There were no cases of complete flap loss, but partial loss occurred in 7 (8.8%) cases. 3 (5.1%) patients required re-operation prior to discharge with one case requiring skin grafting. Delayed surgical revision was required in 4 patients for partial flap loss (2) or stricture/stenosis (2). Conclusion The lotus petal flap is safe for use in gynecologic reconstruction, with acceptable short-and long-term complication rates. Previous reports of smaller series likely underestimate the risk of complications through case selection.

Original languageEnglish (US)
Pages (from-to)726-729
Number of pages4
JournalGynecologic oncology
Volume131
Issue number3
DOIs
StatePublished - Dec 1 2013

Fingerprint

Skin
Pathologic Constriction
Hidradenitis Suppurativa
Skin Transplantation
Reoperation
Melanoma
Pathology
Morbidity
Carcinoma
Wounds and Injuries

Keywords

  • Flap
  • Lotus petal
  • Vulva
  • Vulvar reconstruction
  • Vulvar surgery

Cite this

Argenta, P. A., Lindsay, R., Aldridge, R. B., Siddiqui, N., Burton, K., & Telfer, J. R. C. (2013). Vulvar reconstruction using the "lotus petal" fascio-cutaneous flap. Gynecologic oncology, 131(3), 726-729. https://doi.org/10.1016/j.ygyno.2013.08.030

Vulvar reconstruction using the "lotus petal" fascio-cutaneous flap. / Argenta, Peter A.; Lindsay, Rhona; Aldridge, R. Benjamin; Siddiqui, Nadeem; Burton, Kevin; Telfer, John R.C.

In: Gynecologic oncology, Vol. 131, No. 3, 01.12.2013, p. 726-729.

Research output: Contribution to journalArticle

Argenta, PA, Lindsay, R, Aldridge, RB, Siddiqui, N, Burton, K & Telfer, JRC 2013, 'Vulvar reconstruction using the "lotus petal" fascio-cutaneous flap', Gynecologic oncology, vol. 131, no. 3, pp. 726-729. https://doi.org/10.1016/j.ygyno.2013.08.030
Argenta, Peter A. ; Lindsay, Rhona ; Aldridge, R. Benjamin ; Siddiqui, Nadeem ; Burton, Kevin ; Telfer, John R.C. / Vulvar reconstruction using the "lotus petal" fascio-cutaneous flap. In: Gynecologic oncology. 2013 ; Vol. 131, No. 3. pp. 726-729.
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AU - Telfer, John R.C.

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N2 - Introduction Vulvar reconstruction using the "lotus petal" fascio-cutaneous flap offers a relatively novel means to restore symmetry and functionality after extirpative gynecologic or oncologic procedures. We sought to assess the success rates and morbidity in a large series of consecutively treated patients. Methods We performed a retrospective review of 59 consecutive cases of lotus petal flaps performed at a single institution to more accurately assess success and complication rates. Results We identified 80 flaps performed among the 59 patients between September 1, 2008 and March 30, 2013. The median (range) age was 59 years (24-89) and the median (range) BMI was 27 kg/m 2 (19-34). The indications for vulvar/perineal excision were as follows: 39 (66.1%) vulvar carcinoma or melanoma, 12 (20.3%) vulvar dysplasia, 5 (8.5%) colorectal disease and 3 (5.1%) cases of hidradenitis suppurativa. The mean defect area, determined by post-fixation pathology specimen was 29 cm 2. Medical or surgical complications occurred in 36% of patients of which superficial wound separation was the most common (15%). There were no cases of complete flap loss, but partial loss occurred in 7 (8.8%) cases. 3 (5.1%) patients required re-operation prior to discharge with one case requiring skin grafting. Delayed surgical revision was required in 4 patients for partial flap loss (2) or stricture/stenosis (2). Conclusion The lotus petal flap is safe for use in gynecologic reconstruction, with acceptable short-and long-term complication rates. Previous reports of smaller series likely underestimate the risk of complications through case selection.

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