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KMID : 1190620120080020084
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Journal of the Korean Wound Care Society
2012 Volume.8 No. 2 p.84 ~ p.86
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Reconstruction of Pubic Defects Using Bilateral Advancement Flap in Bladder Exstrophy: A Case Report
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Kim So-Young
Lim So-Young
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Abstract
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Reconstruction of pubic skin defects after bladder exstrophy correction is a challenging problem in respect to aesthetic considerations. The pubic area has a sufficient subcutaneous vascular network from internal and external pudendal arteries and V-Y advancement flap with subcutaneous pedicle can be used safely in the perineal area reconstruction. In this article, we report our experience of the pubic defect reconstruction using V-Y advancement island flap in adult patients bladder exstrophy. 24 years old female patient from Cambodia presented incomplete type of the bladder exstrophy. She had suffered from urinary frequency and incontinence after birth and presented external genitalia deformity. Thus, the reconstruction surgery was planned following the bladder exstrophy correction and perineoplasty performed by Urology surgical team. After the perineoplasty was performed, 15×3 cm soft tissue defect of pubic area was accompanied in the crescent shape bilaterally. We designed bilateral V-Y advancement flap from bilateral inguinal area, with the consideration that scars could be hidden in inguinal crease. The pubic defects could be covered successfully and clitoroplasty was conducted additionally. After the surgery, hospital course was good and there is no immediate postoperative complication. Satisfaction with the postoperative result was very high. The subcutaneous pedicled V-Y advancement flap can be one of the reliable options for the reconstruction of pubic defects after perineoplasty in the bladder exstrophy patients, in the point of not only successful coverage of defects, but also aesthetically satisfactory outcome.
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KEYWORD
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Bladder exstrophy, Bilateral V-Y advancement flap
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