Perineal Reconstruction with a Diamond-shaped Perforator Flap: A Case Report

Summary: Reconstruction of perineal defects is a challenging procedure. Various surgical techniques have been proposed. Compared with traditional myocutaneous flaps, pedicled perforator flaps are believed to be a less invasive option for perineal reconstruction, with better functional and cosmetic results. We present the case of a 47-year-old woman with a perianal Paget's disease who underwent surgical excision of the lesion. The reconstructive technique was a pedicled flap based on an internal pudendal skin perforator artery. The flap was designed in a diamond-shaped pattern. Six months after the operation, the patient is disease-free with successful aesthetic and functional results. A polygonal diamond-shaped flap is an easy and reliable choice for perineal reconstruction, offering better adjustment in the perianal region and avoidance of the curvilinear perianal incision (which often leads to anal stenosis). This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Published online 13 March 2018. Received for publication October 5, 2017; accepted January 12, 2018. Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors. Parthena I. Deskoulidi, MD, St. Savvas Cancer Hospital, St. Alexandras Avenue 171, 11522 Ampelokipoi, Athens, Greece, E-mail: deskoulidinena@yahoo.gr Copyright © 2018 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Plastic Surgeons. All rights reserved.

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