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Surgeons Corner
Local Fasciocutaneous Infragluteal (FCI) Flap for Vulvar and Vaginal Reconstruction: A New Technique in Cancer Surgery
  1. Christian Windhofer, MD*,
  2. Christoph Papp, MD†,
  3. Alfons Staudach, MD‡ and
  4. Wolfgang Michlits, MD§
  1. * Plastic and Reconstructive Surgery, AUVA Trauma Center Salzburg;
  2. † Plastic and Reconstructive Surgery, Medicent Salzburg;
  3. ‡ Department Obstetrics and Gynecology, St. Johanns Hospital Salzburg, Paracelsus Medical University, Salzburg;
  4. § Department of Plastic and Reconstructive Surgery, Hospital Rudolfstiftung, Vienna, Austria.
  1. Address correspondence and reprint requests to Wolfgang Michlits, MD, Hospital Rudolfstiftung, Juchgasse 25, A-1030 Vienna, Austria. E-mail: wolfgang.michlits{at}hotmail.com.

Abstract

Introduction Soft tissue reconstruction after vulvar, vaginal, or anal cancer resection poses a formidable task for reconstructive surgeons because of the functional, locational, and cosmetic importance of this region. Although numerous flaps have been designed for vulvar reconstruction, each has its disadvantages.

Methods The authors introduce the local fasciocutaneous infragluteal (FCI) flap for vulvar and vaginal reconstruction after tumor resection, vaginal scar obliteration, and vulvar ulceration in 15 patients operated on between 1999 and 2007. The FCI flap is supplied by the cutaneous branch of the descending branch of the inferior gluteal artery. The sensory supply of this flap comes from side branches of the posterior cutaneous nerve of the thigh. A total of 17 flaps were performed in 15 patients.

Results Except for one, all flaps survived. One flap necrosis occurred because of false postoperative position with compression and tension to the vascular pedicle. In the remaining patients, we found one local cancer recurrence with necessity of a second flap from the contralateral side. The patients report satisfaction with reconstruction, without one having pain at donor site and recurrent vaginal ulceration.

Conclusions This article discusses the expanding indications of this versatile flap and the operative technique of the local FCI flap for reconstruction of vulvar and partial vaginal defects. It can be raised in different volume and dimension out of possible irradiated area with an inconspicuous scar.

  • Vaginal and vulvar cancer
  • Local FCI flap
  • Defect reconstruction

https://doi.org/10.1097/IGC.0b013e318234fa0a

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    Footnotes

    • The authors did not use any pharmaceutical or industrial support.

    • The authors did not receive any outside funding or grants (National Institutes of Health, Welcome Trust, Howard Hughes Medical Institute, or others) in support of their research or for the preparation of this work.

    • The authors declare that there are no conflicts of interest.