The interrupted V-Y advancement flap for the reconstruction of the vulvovaginal defect

Background: High-quality reconstruction of vulvovaginal defects after tumor excision is critical. Various techniques for vulvovaginal reconstruction have been described. However, these flaps are often bulky, and tip necrosis occasionally occurs. To reduce bulkiness and prevent flap necrosis, we have therefore developed an ideal approach using a fasciocutaneous flap that is advanced in a modified V-Y fashion. Materials and methods: The V-Y flap is interrupted in the defect area by a bipedicled flap and therefore termed "the interrupted V-Y advancement flap". Results: We used the interrupted V-Y advancement flap to cover vulvovaginal defects in five patients who underwent surgical treatment for extramammary Paget's disease or carcinoma of the vulva. Each flap survived completely without complications. Conclusions: This flap is easily elevated, not bulky, and reliable because it is supplied by the internal pudendal artery and vein without excessive skeletonization of the vascular pedicle; it also matches the local skin quality.