Value of V-Y Advancement Flaps in the Coverage of Cutaneous Loss of Substance
Download PDF

Keywords

Horizontal V-Y advancement flap
Tissue defect
Perineal scrotal
Ischial
Sacral tissue defect

DOI

10.26689/dh.v1i1.4996

Submitted : 2023-05-08
Accepted : 2023-05-23
Published : 2023-06-07

Abstract

Objective: We aimed to provide an update and highlight the value of V-Y advancement flaps in the management of cutaneous loss of substance (LOS). Methods: We included 18 patients in whom cutaneous reconstruction was performed at various sites between 2019 and 2021. Skin coverage was provided by means of unilateral or bilateral VY advancement flap. Among the 18 patients, 13 were men and 5 were women. The age of the patients ranged from 8 to 75, with an average age of 46.8. Perineal scrotal reconstruction was performed in 5 cases, sacral in 5 cases, plantar in 3 cases, ischial in 1 case, lumbo-gluteal in 2 cases, retroauricular in 1 case, and forearm in 1 case; 7 cases had bilateral V-Y advancement flap, while 11 cases had unilateral flap. We studied the indications, the size of the defect (4 cm × 5 cm to 20 cm × 30 cm), postoperative complications, and patient satisfaction. Results: No flap defatting was necessary. Long-term results in terms of scarring, functionality, and cosmetic appearance of the reconstructed area were considered satisfactory by the patients. Conclusion: Coverage of cutaneous LOS is a daily procedure for plastic surgeons. Since the V-Y advancement flap is a simple, useful, and reliable coverage technique with low morbidity, it should be an option in cutaneous reconstruction.

References

Revol M, Servant JM, 2010, Suture, in Surgical Techniques – Plastic, Reconstructive and Aesthetic Surgery, Elsevier Masson SAS, Paris,45-030.

Revol M, Servant JM, 2010, Skin Grafts, in Surgical Techniques – Plastic, Reconstructive and Aesthetic Surgery, Elsevier Masson SAS, Paris, 45-070.

Andrades PR, Calderon W, Leniz P, et al., 2005, Geometric Analysis of the V-Y Advancement Flap and Its Clinical Applications. Plast Reconstr Surg, 115(6): 1582–1590.

Pauchot J, Servagi S, Laveaux C, et al., 2010, Coverage of a Dorsal Medial Loss of Substance by Two Latissimus Dorsi Rotation Musculocutaneous Flaps with V-Y Skin Paddle. Geometric Basis and Interest. A Case Report. Annals of Aesthetic Plastic Surgery, 55(1): 66–70.

Yildirim S, Taylan G, Akoz T, 2007, Freestyle Perforator-Based V-Y Advancement Flap for Reconstruction of Soft Tissue Defects at Various Anatomic Regions. Ann Plast Surg, 58(5): 501–506.

Binder JP, Servant JM, Revol M, 2014, Skin Flaps, in Surgical Techniques – Plastic, Reconstructive and Aesthetic Surgery, Elsevier Masson SAS, Paris, 45-080.

Binder JP, Revol M, 2012, Fasciocutaneous Flaps. Surgical Techniques – Plastic, Reconstructive and Aesthetic Surgery, Elsevier Masson SAS, Paris, 45-090.

Binder JP, Servant JM, Revol M, 2012, Perforating Flaps, in Surgical Techniques – Plastic, Reconstructive and Aesthetic Surgery, Elsevier Masson SAS, Paris, 45-096.

Conri V, Gaüzere R, Hocke C, et al., 2010, Study of a Series of Cutaneous-Fat Flaps Based on the Perforators of the Internal Pudendal Artery: Interest in Vulvar Reconstructive Surgery. La Lettre du Gynécologue, 2010(354).

Boucher F, Mojallal A, 2015, Atlas of Perforating Arteries of the Skin, Trunk and Limbs, Elsevier-Manson SAS, Paris.

Ennouhi MA, Kajout M, Moussaoui A, 2016, Interest of Medial Thigh Fasciocutaneous Flap in Fournier’s Gangrene. African Journal of Urology, 22(4): 284–288.

Bonnet F, Paraskevas A, Petit F, et al., 2006, Use of Vacuum-Assisted Closure® for the Reconstruction of a Complex Loss of Substance of the Penis. Ann Chir Plast Esthet, 51(3): 249–252.

Lister GD, Gibson T, 1972, Closure of Rhomboid Skin Defects: The Flaps of Limberg and Dufourmentel. Br J PlastSurg, 25(3): 300–314.

Chu DY, 2003, Mathematical Principle of Planar Z-Plasty. Plast Reconstr Surg, 105(1): 105–108.

Behan FC, 2003, The Keystone Design Perforator Island Flap in Reconstructive Surgery. ANZ J Surg, 73(3): 112–120.

Rini IS, Gunardi AJ, Marsaulina RP, et al., 2020, A Systematic Review of the Keystone Design Perforator Island Flap in the Reconstruction of Trunk Defects. Arch Plast Surg, 47(6): 535–541.

Remache D, Chambert J, Pauchot J, et al., 2015, Numerical Analysis of the V-Y Shaped Advancement Flap. Med Eng Phys, 37(10): 987–994.

Haïdara TM, Amouzou KS, Hissein AH, et al., 2020, Iatrogenic Burns: About 2 Cases. Health Sci Dis, 24(6): 95–98.