1,962 results match your criteria Perineal Reconstruction


Comparison between laparoscopic uterus/sacrocolpopexy and total pelvic floor reconstruction with vaginal mesh for the treatment of pelvic organ prolapse.

J Obstet Gynaecol Res 2019 Jan 16. Epub 2019 Jan 16.

Department of Gynecology and Obstetrics, Development and Related Disease of Women and Children Key Laboratory of Sichuan Province, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China.

Aim: To compare total pelvic floor reconstruction with vaginal mesh (TVM) and laparoscopic uterus/sacrocolpopexy (LSC) for the treatment of pelvic organ prolapse (POP).

Methods: Six hundred and seventy patients with POP stage 3 and 4 underwent LSC (n = 350) or TVM (n = 320) at the West China Second Hospital, Sichuan University between January 2011 and December 2016. Retrospective analysis was done to compare the POP-Q value before operation and 6 months, 5 years after operation, also compare the, patient global impression of change (PGI-C), pelvic floor distress inventory (PFDI-20) and pelvic floor impact questionnaire (PFIQ-7). Read More

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http://doi.wiley.com/10.1111/jog.13908
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http://dx.doi.org/10.1111/jog.13908DOI Listing
January 2019
1 Read

Gluteal Flaps Revisited: Technical Modifications for Perineal Wound Reconstruction.

Ann Plast Surg 2019 Jan 9. Epub 2019 Jan 9.

University of Rochester School of Medicine and Dentistry, Rochester, NY.

Background: Abdominoperineal resection is the treatment for many anorectal malignancies. The laparotomy approach allows for harvest of the rectus abdominis muscle for perineal reconstruction. However, with increasing numbers of robotic abdominoperineal resections being performed, the morbidity associated with a laparotomy incision is avoided. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001771DOI Listing
January 2019
2 Reads

Fournier's Gangrene With Septic Shock and Multiple Organ Dysfunction Syndrome.

Int J Low Extrem Wounds 2019 Jan 8:1534734618818685. Epub 2019 Jan 8.

1 Ruijin Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China.

Fournier's gangrene is a rare, rapidly progressing, and life-threatening infection associated with necrotizing fasciitis in the perineal, genital, and/or lower abdominal regions. Septic shock and multiple organ dysfunction syndrome due to the condition are even rarer events. We describe the case of a 58-year-old man who visited the emergency department with severely painful swelling in the scrotal, perianal, and lower abdominal regions. Read More

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http://dx.doi.org/10.1177/1534734618818685DOI Listing
January 2019
1 Read

Temporary end-on colostomy as a treatment for anastomotic dehiscence after a transanal rectal pull-through procedure in a dog.

Vet Surg 2019 Jan 7. Epub 2019 Jan 7.

Centro Veterinario Luni Mare, La Spezia, Italy.

Objective: To describe a temporary end-on colostomy to treat the dehiscence of a transanal rectal pull-through in a dog.

Study Design: Case report ANIMAL: A 7-year-old intact female Australian shepherd dog that was treated for a rectal adenocarcinoma with a transanal rectal pull-through.

Methods: Partial dehiscence of the previous end-to-end colorectal anastomosis and formation of a perianal sinus tract were diagnosed 4 days after surgery. Read More

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http://dx.doi.org/10.1111/vsu.13152DOI Listing
January 2019
2 Reads

The adipofasciocutaneous gluteal fold perforator flap a versatile alternative choice for covering perineal defects.

Int J Colorectal Dis 2019 Jan 4. Epub 2019 Jan 4.

Department of Plastic and Hand Surgery, Faculty of Medicine, University of Freiburg, im Breisgau, Germany.

Aim: Perineal defects following the resection of anorectal malignancies are a reconstructive challenge. Flaps based on the rectus abdominis muscle have several drawbacks. Regional perforator flaps may be a suitable alternative. Read More

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http://dx.doi.org/10.1007/s00384-018-03222-wDOI Listing
January 2019

Simultaneous stoma reinforcement and perineal reconstruction with biological mesh - A multicentre prospective observational study.

Ann Med Surg (Lond) 2019 Feb 21;38:28-33. Epub 2018 Dec 21.

Department of Colorectal Surgery, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicestershire, UK.

Introduction: The optimal method for perineal reconstruction after extralevator abdominoperineal excision (elAPE) for low rectal cancer remains controversial. This study aimed to assess whether simultaneous perineal reconstruction and parastomal reinforcement with Strattice™ Reconstructive Tissue Matrix after elAPE could prevent hernia formation.

Methods: In this prospective, multicentre, observational, non-comparative study of consecutive patients undergoing elAPE for low rectal cancer underwent simultaneous perineal reconstruction and colostomy site reinforcement with Strattice™ mesh. Read More

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http://dx.doi.org/10.1016/j.amsu.2018.12.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308243PMC
February 2019

Pedicled Abdominal Flaps for Enhanced Digital Salvage After Severe Frostbite Injury.

Wilderness Environ Med 2018 Dec 24. Epub 2018 Dec 24.

Department of Vascular Surgery, University Hospital Coventry and Warwickshire, Coventry, UK; Warwick Medical School, University of Warwick, Coventry, UK.

Extremities are the area of the body most commonly affected by frostbite, which can also affect the face, ears, perineum, or genitals. Optimum management has moved away from early amputation and debridement toward maximizing tissue preservation and delaying surgical intervention. Increasing length of digit amputation increases morbidity, in terms of loss of hand function, experienced by patients. Read More

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http://dx.doi.org/10.1016/j.wem.2018.09.003DOI Listing
December 2018
1 Read

Reconstruction of urethral defects using a fascia lata autograft in a dog.

J Vet Med Sci 2018 Dec 26. Epub 2018 Dec 26.

Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University.

A castrated male Shih-Tzu dog was presented for evaluation of urine leakage after urethrotomy. A fistula with urine leakage was identified in the perineal region. On retrograde urethrography, the contrast extravasated from the penile urethra into the subcutaneous tissue of the perineum. Read More

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http://dx.doi.org/10.1292/jvms.18-0190DOI Listing
December 2018

Expanding the applications of the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for extensive defects.

Microsurgery 2018 Dec 17. Epub 2018 Dec 17.

Department of Plastic and Reconstructive Surgery, China Medical University, Taichung, Taiwan.

Background: The medial thigh is a well-hidden area. The two most common flaps from this area are the transverse upper gracilis (TUG) and profunda artery perforator (PAP) flaps. Herein, we explored the applications of combined TUGPAP flap to reconstruct large and complex defects in different regions. Read More

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http://dx.doi.org/10.1002/micr.30413DOI Listing
December 2018

Modified V-Y Fasciocutaneous Flap Reconstruction After Abdominoperineal Resection in Irradiated Patients Prevents Wound Dehiscence and Associated Complications: A Retrospective Analysis and Benchtop Confirmation.

Ann Plast Surg 2019 Feb;82(2):218-223

Division of Plastic and Reconstructive Surgery, Duke University Medical Center, Durham NC.

Background: Primary perineal closure following abdominal perineal resection (APR) is reported to have a wound complication rate as high as 66%, whereas flap reconstruction reduces wound complications to 15% to 35%. A modified de-epithelialized V-Y fasciocutaneous flap aims to further improve results in this patient population.

Methods: To study the breaking force of a simple interrupted suture in either skin or subcutaneous fat, various quantitative assessments were performed in a porcine flap model using uniaxial static tensile testing with an Instron tensiometer, with a single or triple row of 3 Vicryl sutures in both skin and fat. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001672DOI Listing
February 2019
1 Read

Addressing the empty pelvic syndrome following total pelvic exenteration: does mesh reconstruction help?

Colorectal Dis 2018 Dec 7. Epub 2018 Dec 7.

Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia.

Aim: Perineal wound complications and pelvic abscesses remain a major source of morbidity after total pelvic exenteration. The void created in the pelvis after these multi-visceral resections leads to fluid accumulation and translocation of bowel within the pelvic cavity, which may increase the risk of pelvic abscess, perineal fluid discharge with perineal wound dehiscence and prolonged ileus. This study describes a novel technique using degradable synthetic mesh with overlying omentum to preclude small bowel and fill the empty space after total pelvic exenteration, and aimed to investigate the rate of pelvic abscess and perineal wound-related complications in this group. Read More

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http://dx.doi.org/10.1111/codi.14523DOI Listing
December 2018
2 Reads

Radiculoplasty with reconstruction using 3D-printed artificial dura mater for the treatment of symptomatic sacral canal cysts: Two case reports.

Medicine (Baltimore) 2018 Dec;97(49):e13289

Department of Neurosurgery, Peking University Third Hospital, Beijing, China.

Rationale: Currently, interventional injection of albumin glue and nerve sleeve plasty by cyst excision is the main treatment for sacral cysts. However, albumin glue can only be used in patients with partial cystic neck stenosis, and surgical treatment may result in postoperative complications such as numbness and cyst recurrence. Here, a modified radiculoplasty is presented, in which the lamina is restored with the nerve root wrapped with 3-dimensional (3D)-printed artificial dura mater. Read More

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http://dx.doi.org/10.1097/MD.0000000000013289DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310578PMC
December 2018

Analysis of prognostic factors affecting poor outcomes in 41 cases of Fournier gangrene.

Ann Surg Treat Res 2018 Dec 26;95(6):324-332. Epub 2018 Nov 26.

Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea.

Purpose: We present our experience involving the management of this disease, identifying prognostic factors affecting treatment outcomes.

Methods: The patients treated for Fournier gangrene at our institution were retrospectively reviewed. Data collected included demographics, extent of soft tissue necrosis, predisposing factors, etiological factors, laboratory values, and treatment outcomes. Read More

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https://synapse.koreamed.org/DOIx.php?id=10.4174/astr.2018.9
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http://dx.doi.org/10.4174/astr.2018.95.6.324DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255751PMC
December 2018
5 Reads

[A giant sacral chordoma resection and reconstruction with a gluteal perforator flap, a case report and literature review].

Ann Chir Plast Esthet 2018 Nov 30. Epub 2018 Nov 30.

Service de chirurgie orthopédique et traumatologie, chirurgie du rachis, hôpital Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.

Background: Sacral chordomas are rare primary bone tumors and represent more than half of all primary malignant sacral tumors. Surgical resection is the only treatment with close to 50% of remission at 10 years, with or without radiotherapy. This tissue removal can be very extensive and morbid, particularly for evolved tumors. Read More

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http://dx.doi.org/10.1016/j.anplas.2018.10.004DOI Listing
November 2018
3 Reads

Squamous cell carcinoma of the anal canal.

Curr Probl Cancer 2018 Sep 23;42(5):486-492. Epub 2018 Nov 23.

Brigham and Women's Hospital, Boston, Massachusetts.

Anal squamous cell carcinoma (SCC) is a rare cancer and accounts for approximately 4% of all cancers of the lower alimentary tract. The dominant etiology is infection with human papilloma virus (HPV), which is the most common sexually transmitted disease in the United States. Integration of HPV DNA into the host genome seems to be the driving mechanism behind carcinogenesis. Read More

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http://dx.doi.org/10.1016/j.currproblcancer.2018.11.001DOI Listing
September 2018
1 Read

Outcome of patients with failed pelvic fracture-associated urethral injury repair: A single centre 10-year experience.

Turk J Urol 2018 Nov 21:1-6. Epub 2018 Nov 21.

King George's Medical University, Lucknow, India.

Objective: The management of recurrent posterior urethral strictures developing after pelvic fracture urethral injury (PFUI) is a challenging task. Despite availability of many surgical approaches, there is no consensus regarding the optimal approach. The objective of this study was to present our 10-year experience in the management of recurrent urethral strictures due to PFUI. Read More

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http://turkishjournalofurology.com/eng/makale/3362/155/Full-
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http://dx.doi.org/10.5152/tud.2018.36824DOI Listing
November 2018
7 Reads

Negative Pressure Wound Therapy with Instillation and Dwell Time in the Surgical Management of Severe Hidradenitis Suppurativa.

Cureus 2018 Sep 17;10(9):e3319. Epub 2018 Sep 17.

Plastic and Reconstructive Surgery, University of Maryland School of Medicine, Baltimore, USA.

Background: Hidradenitis suppurativa (HS) is a physically debilitating disease that greatly impairs the quality of life of affected individuals. Advanced disease is often difficult to treat with topical and systemic therapies. Surgical resection of diseased skin has become paramount in HS management but proposes challenges of wound care and closure. Read More

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https://www.cureus.com/articles/14557-negative-pressure-woun
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http://dx.doi.org/10.7759/cureus.3319DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248873PMC
September 2018
9 Reads

Early ambulation after colorectal oncologic resection with perineal reconstruction is safe and effective.

Am J Surg 2018 Oct 10. Epub 2018 Oct 10.

Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:

Background: Post-operative bedrest is common following perineal reconstruction despite little supporting data. We sought to determine the safety of early ambulation following colorectal oncologic resection and flap-based perineal reconstruction.

Methods: A retrospective cohort study was conducted with two cohorts: standard bedrest (BC) and early ambulation (EAC). Read More

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http://dx.doi.org/10.1016/j.amjsurg.2018.10.005DOI Listing
October 2018
4 Reads

Robotic-assisted Proximal Perineal Urethroplasty: Improving Visualization and Ergonomics.

Urology 2018 Nov 16. Epub 2018 Nov 16.

Department of Urology, University of California San Diego, San Diego, CA. Electronic address:

Objective: To describe the use of the robotic platform for proximal suture placement during perineal urethroplasty in the posterior and proximal anterior urethra. Repair of posterior urethral and proximal bulbar strictures requires deep perineal dissection, making visualization and accurate placement of sutures challenging. The robotic platform has demonstrated benefits in these characteristics in deep pelvic surgery. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00904295183120
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http://dx.doi.org/10.1016/j.urology.2018.11.011DOI Listing
November 2018
7 Reads

Primary vs myocutaneous flap closure of perineal defects following abdominoperineal resection for colorectal disease: a systematic review and meta-analysis.

Colorectal Dis 2018 Nov 14. Epub 2018 Nov 14.

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China.

Aim: Perineal wound complications after abdominoperineal resection (APR) have become a major clinical challenge. Myocutaneous flap closure has been proposed in place of primary closure to improve wound healing. We conducted this comprehensive meta-analysis to evaluate the current scientific evidence of primary closure vs myocutaneous flap closure of perineal defects following APR for colorectal disease. Read More

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http://doi.wiley.com/10.1111/codi.14471
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http://dx.doi.org/10.1111/codi.14471DOI Listing
November 2018
16 Reads

New porcine model of perineal tear and its utility in physicians' training on the reconstruction of 3rd and 4th degree perineal tear during vaginal delivery.

Ginekol Pol 2018 ;89(10):558-562

Warsaw Proctology Centre, Saint Elisabeth Hospital, Warsaw, Poland, Poland; Department of General Surgery, District Hospital in Wołomin, Poland, Gdynska 1/3, 05-200 Wolomin, Poland.

Objectives: One of the most serious complications of vaginal delivery is 3rd and 4th degree perineal tear and its incorrect management results in anal incontinence. Animal-based anatomical models of childbirth-induced perineal tear are an important element of the physicians' practical training [1]. The proposed new model, prepared using porcine tongue and intestine, closely mimics all the tissues and organs subjected to injury during complicated deliveries and constitutes an educational opportunity for the reconstruction of the injuries. Read More

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http://dx.doi.org/10.5603/GP.a2018.0095DOI Listing
January 2018
6 Reads

Case report of squamous cell cancer arising in perineal epidermal inclusion cyst, presenting as rapidly enlarging and cavitating lesion.

Int J Surg Case Rep 2018 29;53:115-119. Epub 2018 Oct 29.

Dermatology, OhioHealth Marion Area Physicians, Marion Medical Campus, 1040 Delaware Avenue, 43302 Marion, OH, USA. Electronic address:

Introduction: Cutaneous squamous cell cancer (cSCC) is a common condition, with straight forward and well-known heuristics regarding diagnosis, treatment, and surveillance. cSCC arising in an epidermal inclusion cyst is rare, but not unheard of. In contrast, the authors' are unaware of any prior reports of cSCC arising in an epidermal inclusion cyst within an atypical cavernous and cavitating lesion in the perineum. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S22102612183047
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http://dx.doi.org/10.1016/j.ijscr.2018.10.054DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6216085PMC
October 2018
5 Reads

The Treatment of Genitoperineal Hidradenitis Suppurativa: A Review of the Literature.

Urology 2018 Nov 2. Epub 2018 Nov 2.

Department of Urology, The George Washington University School of Medicine and Health Sciences, Washington, DC.

Hidradenitis suppurativa is a chronic inflammatory condition affecting the axilla, genitals, perineum, and perianal regions. The pathophysiology of hidradenitis suppurativa is complex and requires a multidisciplinary approach to treatment involving medical and surgical management when indicated. We describe our multidisciplinary protocol for treatment, which includes rheumatology-monitored immunotherapy, medical management, wide surgical resection, wound care, and reconstruction. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00904295183109
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http://dx.doi.org/10.1016/j.urology.2018.10.013DOI Listing
November 2018
10 Reads

Modified posterior intravaginal slingplasty: does the additional bilateral tape attachment to the sacrospinous ligament improve the results?

Cent European J Urol 2018 25;71(3):326-333. Epub 2018 Jun 25.

Carpe Vitam, Center of Reconstructive Pelvic Floor Surgery, Hannover, Germany.

Introduction: High failure and recurrent prolapse remains an important issue for pelvic organ prolapse (POP) surgery. The posterior intravaginal slingplasty (PIVS) is a minimally invasive, transperineal technique providing level I support, by creating neo-sacrouterine ligaments using a mesh. In order to reduce the POP recurrence rate, achieve a safer apical support and thereby better functional outcomes, we attached PIVS tape to the sacrospinous ligament bilaterally and compared the anatomical and functional outcomes for our modified technique versus the original PIVS. Read More

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http://dx.doi.org/10.5173/ceju.2018.1685DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6202626PMC
June 2018
1 Read

Early vaginal replacement in cloacal malformation.

Pediatr Surg Int 2019 Feb 30;35(2):263-269. Epub 2018 Oct 30.

Department of Pediatric Surgery, All India Institute of Medical Sciences, Room no. 4001-2, Ansari Nagar, New Delhi, 110029, India.

Purpose: We assessed the surgical outcome of cloacal malformation (CM) with emphasis on need and timing of vaginal replacement.

Methods: An ambispective study of CM was carried out including prospective cases from April 2014 to December 2017 and retrospective cases that came for routine follow-up. Early vaginal replacement was defined as that done at time of bowel pull through. Read More

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http://link.springer.com/10.1007/s00383-018-4407-1
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http://dx.doi.org/10.1007/s00383-018-4407-1DOI Listing
February 2019
10 Reads
1.060 Impact Factor

Obstetrical Outcomes in Adult Patients Born with Complex Anorectal Malformations and Cloacal Anomalies: A Literature Review.

J Pediatr Adolesc Gynecol 2019 Feb 24;32(1):7-14. Epub 2018 Oct 24.

Nationwide Children's Hospital, Columbus, Ohio.

Patients born with complex anorectal malformations often have associated Müllerian anomalies, which might affect fertility and obstetrical outcomes. Other vertebral-anorectal-tracheoesophageal-renal-limb associations, such as renal or cardiac anomalies, could also affect pregnancy intention, fertility rates, and recommendations about mode of delivery or obstetrical outcomes. Associated conditions present at birth, like hydrocolpos, could also potentially affect fertility. Read More

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http://dx.doi.org/10.1016/j.jpag.2018.10.002DOI Listing
February 2019
12 Reads

Experience with gluteal V-Y fasciocutaneous advancement flaps in vulvar reconstruction after oncological resection and a modification to the marking: Playing with tension lines.

Int Wound J 2019 Feb 10;16(1):96-102. Epub 2018 Oct 10.

Plastic Surgery Service, Ospedale Santa Maria della Misericordia, Udine, Italy.

Many post-vulvectomy vulvar reconstruction solutions, using local fasciocutaneous flaps where possible, have been proposed. We report the use of V-Y advancement flaps from the gluteal fold in medium to large vulvar reconstructions and a simple modification we made to the technique in order to minimise wound-related complications. Between 2006 and 2016, 30 vulvar reconstructions were performed via a total of 59 flaps, 24 of which were raised using the proposed modification to the plasty design. Read More

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http://dx.doi.org/10.1111/iwj.12997DOI Listing
February 2019
1 Read

Outcomes in Fournier's Gangrene Using Skin and Soft Tissue Sparing Flap Preservation Surgery for Wound Closure: An Alternative Approach to Wide Radical Debridement.

Wounds 2018 Oct;30(10):290-299

Wright State University, Boonshoft School of Medicine, Division of Plastic Surgery, Dayton, OH.

Introduction: Fournier's gangrene (FG) remains a forbidding necrotizing soft tissue infection (NSTI) that necessitates early recognition, prompt surgical excision, and goal-directed antibiotic therapy. Traditionally, surgical management has included wide radical excision for sepsis control, but this management often leaves large, morbid wounds that require complex wound coverage, prolonged hospitalizations, and/or delayed healing.

Objective: The purpose of this case series is to report the outcomes of FG using a surrogate approach of concurrent debridement of spared skin and soft tissue, negative pressure wound therapy (NPWT), and serial delayed primary closure (DPC). Read More

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October 2018
14 Reads

Laparoscopically Assisted Vaginal Pull-Through in 7 Cases of Congenital Adrenal Hyperplasia with High Urogenital Sinus Confluence: Early Results.

J Laparoendosc Adv Surg Tech A 2018 Sep 25. Epub 2018 Sep 25.

2 Department of Pediatric Surgery, Cairo University Specialized Pediatric Hospital , Faculty of Medicine (Kasr Alainy), Cairo, Egypt .

Introduction: Surgical management of the high urogenital sinus (UGS) is challenging. Presence of a short urethra is a contraindication for UGS mobilization as this is likely to affect urinary continence. In addition, vaginal reconstruction of the high suprasphincteric confluence is complex and prone to complications and failure. Read More

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http://dx.doi.org/10.1089/lap.2018.0194DOI Listing
September 2018

Negative pressure wound therapy and split thickness skin graft aided in the healing of extensive perineum necrotizing fasciitis without faecal diversion: a case report.

BMC Surg 2018 Sep 24;18(1):77. Epub 2018 Sep 24.

Department of Plastic and Cosmetic Surgery, Xinqiao Hospital, Army Medical University, Xinqiao Road, Sha Ping Ba District, Chongqing, 400037, People's Republic of China.

Background: Perineum necrotizing fasciitis, also known as Fournier gangrene (FG), is a rare but highly mortal infectious necrotizing fasciitis with or without involvement of the underlying muscle. Evidence exists that negative pressure wound therapy (NPWT) combined with a split thickness skin graft (STSG) can help to heal wounds with FG. However, when the wound spreads to the anal area, it can easily be contaminated by faeces, causing a more extensive wounds; thus, faecal diversion is considered. Read More

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http://dx.doi.org/10.1186/s12893-018-0411-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6154412PMC
September 2018
15 Reads

[Management of vesicourethral anastomotic stenosis after radical prostatectomy].

Rev Int Androl 2018 Sep 17. Epub 2018 Sep 17.

Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España; Facultad de Medicina, Universidad de Cantabria, Santander, Cantabria, España.

Vesicourethral anastomotic stenosis is a relatively uncommon problem after radical prostatectomy, but it could become recurrent and difficult to treat. Risk factors are known, and they can help to decrease the incidence. When discussing the therapeutic plan, we must consider the stenosis risk, and also the urinary continence after the prostatectomy. Read More

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http://dx.doi.org/10.1016/j.androl.2018.05.003DOI Listing
September 2018
7 Reads

Anatomy and techniques in posterior urethroplasty.

Transl Androl Urol 2018 Aug;7(4):567-579

Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Given its complex anatomy, injury to the posterior urethra may result in a number of reconstructive challenges. With the appropriate operative planning and experience, surgical repair can be very successful. This review discusses the applicable techniques for the perineal approach to posterior urethral stenosis, including bulbomembranous anastomosis for pelvic fracture urethral injury and repair of vesicourethral anastomotic stenosis (VUAS) following prostate surgery. Read More

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http://dx.doi.org/10.21037/tau.2018.03.05DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6127558PMC
August 2018
1 Read

Closure of the perineal defect after abdominoperineal excision for rectal adenocarcinoma - ACPGBI Position Statement.

Colorectal Dis 2018 Sep;20 Suppl 5:5-23

University of Bath, Bath, UK.

Background: Perineal wound morbidity is common following abdominoperineal excision of the rectum (APE). There is no consensus on the optimum perineal reconstruction method after APE, and in particular 'extra-levator APE' (ELAPE).

Methods: A systematic review of the PubMed, Embase and Cochrane databases was performed. Read More

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http://dx.doi.org/10.1111/codi.14348DOI Listing
September 2018

A new technique of scrotoplasty following total scrotal destruction by raised rotated perineal flaps with de epithelialized borders.

Urol J 2018 Aug 26. Epub 2018 Aug 26.

Department of female urology, Shahid Hasheminejad Hospital, Iran university of medical sciences, Tehran, Iran.

In this article we present two-year-old male patient who had history of Fournier gangrene of scrotum. Extensive perineal and scrotal debridement with suprapubic cystostomy tube insertion had been done for him in the emergency setting One year later his parents brought him back for scrotal reconstruction. A novel technique by using rotational perineal flap was used. Read More

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http://dx.doi.org/10.22037/uj.v0i0.4170DOI Listing
August 2018
5 Reads
0.710 Impact Factor

Changing Trends in Reconstruction of Complex Anterior Urethral Strictures: From Skin Flap to Perineal Urethrostomy.

Urology 2018 Dec 20;122:169-173. Epub 2018 Aug 20.

Department of Urology, UT Southwestern Medical Center, Dallas, TX. Electronic address:

Objective: To evaluate procedural trends and outcomes for reconstruction of complex strictures at our tertiary center over the last decade.

Methods: We retrospectively reviewed complex urethral reconstruction comparing 3 techniques: (1) buccal mucosal graft (BMG), (2) penile skin flap, or (3) perineal urethrostomy (PU) at our center (2007-2017) with ≥6 months follow-up. Strictures amenable to anastomotic repair were excluded. Read More

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http://dx.doi.org/10.1016/j.urology.2018.08.009DOI Listing
December 2018
9 Reads

Application of modified primary closure of the pelvic floor in laparoscopic extralevator abdominal perineal excision for low rectal cancer.

World J Gastroenterol 2018 Aug;24(30):3440-3447

Department of Colorectal and Anal Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.

Aim: To introduce a novel, modified primary closure technique of laparoscopic extralevator abdominal perineal excision (LELAPE) for low rectal cancer.

Methods: We retrospectively analyzed data from 76 patients with rectal cancer who underwent LELAPE from March 2013 to May 2016. Patients were classified into the modified primary closure group (32 patients) and the biological mesh closure group (44 patients). Read More

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http://www.wjgnet.com/1007-9327/full/v24/i30/3440.htm
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http://dx.doi.org/10.3748/wjg.v24.i30.3440DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092585PMC
August 2018
6 Reads

Inferiorly based lotus petal flap & laser therapy in difficult pilonidal sinus management.

J Plast Reconstr Aesthet Surg 2018 Nov 8;71(11):1631-1636. Epub 2018 Jun 8.

St Helens & Knowsley NHS trust, UK. Electronic address:

Aim: To assess the efficacy of the lotus petal flap in difficult pilonidal sinus management.

Background: Pilonidal sinuses may be difficult to treat. Five year recurrence rates range from 18% to 50% Recurrence rates fall with primary closure rather than healing by secondary intention. Read More

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http://dx.doi.org/10.1016/j.bjps.2018.05.014DOI Listing
November 2018
1 Read

Incidence and risk factors associated with infection after intramedullary nailing of femoral and tibial diaphyseal fractures: Prospective study.

Injury 2018 Oct 27;49(10):1905-1911. Epub 2018 Jul 27.

Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.

Background: Diaphyseal fractures of femur and tibia are prominent due to its high incidence and high economic and social impact. Intramedullary nailing (IN) is the surgical procedure of choice. Surgical site infection (SSI) related to this procedure is considered a difficult to treat complication. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00201383183040
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http://dx.doi.org/10.1016/j.injury.2018.07.024DOI Listing
October 2018
8 Reads

Bridging the Gap: A 20-Year Experience with Vein Grafts for Free Flap Reconstruction. The Odds for Success.

Plast Reconstr Surg 2018 09;142(3):786-794

Chicago, Ill. From the Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago Medical Center.

Background: Successful free tissue transfer requires tension-free microvascular anastomosis. Vein grafts are used when this cannot be obtained, which increases microsurgical complexity and the chance of vessel thrombosis. Previous studies on vein grafts are limited to low numbers and selected techniques, making it difficult to draw conclusions. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004697DOI Listing
September 2018

Aphallia: A Very Rare Congenital Anomaly, With Associated Genitourinary And Ano-Rectal Malformation.

J Ayub Med Coll Abbottabad 2018 Apr-Jun;30(2):275-277

Rawalpindi Medical College, Pakistan.

Aphallia or penile agenesis is very rare congenital anomaly of unknown cause occurring 1 in 30 million live births. Very little has been written in literature about aphallia. There is absent phallus and urethra may open abnormally in perineum or into rectum posing various surgical, social and psychological implications as the child grows. Read More

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October 2018

Treatment of Genital Burn Injuries: Traditional Procedures and New Techniques.

Adv Skin Wound Care 2018 Jul;31(7):314-321

In the Department of Plastic Surgery, Hand Surgery, and Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center, Cologne, Germany, Alexandra Schulz, MD, is a Senior Resident; Benedikt Ribitsch, MD, is a Resident; Paul Christian Fuchs, PhD, is Professor and Director; Alexandra Lipensky, MD, is a Resident; and Jennifer Lynn Schiefer, MD, is a Senior Resident. Acknowledgments: The NexoBrid product for enzymatic debridement has been approved for use in Germany and is currently an investigational product in a phase III controlled FDA trial in the United States. Dr Schulz has disclosed that she is a consultant for MediWound Ltd, although the current study was not funded by the product manufacturer. The authors have disclosed no other financial relationships related to this article. Submitted February 19, 2017; accepted in revised form August 3, 2017.

Objective: Because genital burns are rare, only limited information on treatment guidelines is available in the literature. Vital tissue should be preserved to promote spontaneous healing because reconstruction does not always lead to satisfying results. The aim of this report is to present a general overview of current, prevailing treatment for genital burns and compare this to study authors' experiences. Read More

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http://dx.doi.org/10.1097/01.ASW.0000532474.34841.d0DOI Listing
July 2018
13 Reads

[Gluteal flap harvest for breast reconstruction].

Ann Chir Plast Esthet 2018 Nov 18;63(5-6):498-504. Epub 2018 Jun 18.

Service de chirurgie plastique, hôpital Salengro, CHRU de Lille, 59037 Lille cedex, France. Electronic address:

The lower gluteal flap is an autologous microsurgical breast reconstruction procedure using the soft tissue of the region of the gluteal sulcus. The perineal extension increases the volume of the sample. The pedicle with one artery and two large veins extends up the ischial notch and can reach 8 to 12cm. Read More

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http://dx.doi.org/10.1016/j.anplas.2018.05.003DOI Listing
November 2018
2 Reads

Perineal Wound Complications Following Extralevator Abdominoperineal Excision: Experience of a Regional Cancer Center.

Indian J Surg Oncol 2018 Jun 14;9(2):211-214. Epub 2018 Apr 14.

1Department of Surgical Oncology, Cancer Institute (WIA), Chennai, 600036 India.

Extralevator abdominoperineal excision (ELAPE) results in a large perineal defect which needs reconstruction by a flap or biological mesh. The incidence of perineal wound complications is thought to be higher following an ELAPE compared to conventional abdominoperineal excision (APE). WE aimed to analyze the perineal wound complications following ELAPE in our institution. Read More

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http://link.springer.com/10.1007/s13193-018-0741-y
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http://dx.doi.org/10.1007/s13193-018-0741-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984859PMC
June 2018
3 Reads

Which Therapeutic Option Is Optimal for Surgery-Related Perineal Hernia After Abdominoperineal Excision in Patients with Advanced Rectal Cancer? A Report of 3 Thought-Provoking Cases.

Am J Case Rep 2018 Jun 8;19:663-668. Epub 2018 Jun 8.

Department of Digestive Surgery, Tenri Hospital, Tenri, Nara, Japan.

BACKGROUND Although perineal hernia (PH) is considered a surgery-related complication after abdominoperineal excision, the optimal therapeutic option for PH remains controversial. CASE REPORT The first case involved a 72-year-old man in whom PH was diagnosed 6 months after surgery. Laparoscopic findings revealed moderate adhesion at the pelvic floor, and a perineal approach was added. Read More

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http://dx.doi.org/10.12659/AJCR.909393DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024713PMC

En Bloc Surgical Dissection for Penile Transplantation for Trans-Men: A Cadaveric Study.

Biomed Res Int 2018 8;2018:6754030. Epub 2018 May 8.

Department of Transplantation Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Göteborg, Sweden.

Introduction: The surgical techniques currently available for penile reconstruction for trans-men with gender dysphoria present with multiple drawbacks and often fail to meet patients' expectations. Literature reports three cases where penile transplantation has been performed for cis-men, with the last two cases being considered successful.

Aim: To determine whether an en bloc surgical dissection can be performed in a male cadaver, in order to include structures necessary for penile transplantation (from a deceased donor male) to a recipient with female genitalia in gender affirmation surgery. Read More

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http://dx.doi.org/10.1155/2018/6754030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964499PMC
October 2018

[Establishment and application of three-dimensional model of deep inferior epigastric artery perforator flap based on computed tomography angiography].

Zhonghua Shao Shang Za Zhi 2018 May;34(5):297-302

Department of Burns and Plastic Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China.

To explore the establishment and application of three-dimensional model of deep inferior epigastric artery perforator flap based on computed tomography angiography (CTA). Six patients with breast absence after modified radical mastectomy because of breast cancer, 5 patients with congenital absence of vagina, and 6 patients with Paget's disease of penis and scrotum were hospitalized in our unit from January 2012 to April 2017. The size of wounds after excision of the lesion or that of flaps needed for reconstruction ranged from 17 cm×5 cm to 25 cm×9 cm. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1009-2587.2018.05.010DOI Listing
May 2018
4 Reads

Patency and Incontinence Rates After Robotic Bladder Neck Reconstruction for Vesicourethral Anastomotic Stenosis and Recalcitrant Bladder Neck Contractures: The Trauma and Urologic Reconstructive Network of Surgeons Experience.

Urology 2018 Aug 16;118:227-233. Epub 2018 May 16.

Uropartners, Gurnee, IL.

Objective: To review a robotic approach to recalcitrant bladder neck obstruction and to assess success and incontinence rates.

Materials And Methods: Patients with a recalcitrant bladder neck contracture or vesicourethral anastomotic stenosis who underwent robotic bladder neck reconstruction (RBNR) were identified. We reviewed patient demographics, medical history, etiology, previous endoscopic management, cystoscopic and symptomatic outcomes, urinary continence, and complications. Read More

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http://dx.doi.org/10.1016/j.urology.2018.05.007DOI Listing
August 2018
10 Reads

Perineal Wound Closure Using Biological Mesh Following Extralevator Abdominoperineal Excision.

Dig Surg 2018 May 15:1-8. Epub 2018 May 15.

Division of Coloproctology, Center of Digestive Diseases, Karolinska, University Hospital, Stockholm, Sweden.

Aims: This study aimed to describe the short-term perineal healing rates in patients with perineal reconstruction using a biological mesh following extralevator abdominoperineal excision (elAPE).

Methods: In a retrospective, descriptive single-centre cohort study, 88 consecutive patients treated with elAPE and perineal closure using a biological mesh between January 2011 and December 2015 were reviewed. All available data from electronic hospital records was collected. Read More

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http://dx.doi.org/10.1159/000489134DOI Listing

A Review of the Surgical Management of Perineal Hernias in Dogs.

J Am Anim Hosp Assoc 2018 Jul/Aug;54(4):179-187. Epub 2018 May 14.

From the Dallas Veterinary Surgical Center, Dallas, Texas.

Perineal hernia refers to the failure of the muscular pelvic diaphragm to support the rectal wall, resulting in herniation of pelvic and, occasionally, abdominal viscera into the subcutaneous perineal region. The proposed causes of pelvic diaphragm weakness include tenesmus associated with chronic prostatic disease or constipation, myopathy, rectal abnormalities, and gonadal hormonal imbalances. The most common presentation of perineal hernia in dogs is a unilateral or bilateral nonpainful swelling of the perineum. Read More

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http://dx.doi.org/10.5326/JAAHA-MS-6490DOI Listing
September 2018
29 Reads