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Better Anatomical and Cosmetic Results Using Tunneled Lotus Petal Flap for Plastic Reconstruction After Demolitive Surgery for Vulvar Malignancy
  1. Alessandro Buda, MD*,
  2. Pier Luigi Confalonieri, MD,
  3. Luca Carlo Vittorio Rovati, MD,
  4. Robert Fruscio, MD*,
  5. Daniela Giuliani, MD*,
  6. Mauro Signorelli, MD*,
  7. Tiziana Dell’Anna, MD*,
  8. Cecilia Pirovano, MD* and
  9. Rodolfo Milani, Professor*
  1. *Department of Obstetrics and Gynecology, and
  2. Division of Plastic Surgery, University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.
  1. Address correspondence and reprint requests to Alessandro Buda, MD, Department of Obstetrics and Gynecology, Via Pergolesi, 33, 20900 Monza (MB), Italy. E-mail:


Objective To evaluate the efficacy of tunneled lotus petal flap in terms of anatomical and cosmetic results in patients who underwent vulvoperineal reconstruction for vulvar malignancy.

Methods Between March 2010 and July 2011, 22 women underwent vulvoperineal reconstruction using tunneled lotus petal flap for primary or recurrent disease at San Gerardo Hospital, Monza. In 16 cases, lotus flaps were bilateral, whereas in 6 cases, they were monolateral.

Results The median age was 72 years (range, 53–87 years). The mean operating time was 85 minutes. The mean length of follow-up was 10 months (range, 2–16 months). Postoperative complications occurred in 2 patients, including one case of partial flap necrosis and one case of donor site breakdown.

Conclusions Tunneled lotus petal flap is safe, easy and fast to perform, has a low rate of complications, and good functional and cosmetic results. This technique represents an optimal solution for plastic reconstruction in case of primary or recurrent vulvar disease, or in case of introital stenosis after primary inadequate closure.

  • Vulvar neoplasm
  • Plastic surgery
  • Tunneled lotus petal flap

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  • The authors have no conflicts of interest to declare.