Vulvar reconstruction by a "supra-fascial" lotus petal flap after surgery for malignancies.

OBJECTIVE: The aim of this study is to report on our experience with the supra-fascial lotus petal flap following the resection of vulvar cancer. METHODS: The original lotus petal flap or gluteal-fold flap technique was initially described with fascial elevation. However, flap harvesting in a supra-fascial plane is feasible. Between 2008 and 2011, we performed and evaluated this modified flap technique for labia majora reconstruction on five elderly females (mean age: 72 years). RESULTS: Resection and reconstruction were performed in the same operative time with a median time procedure of 118 min. We observed neither flap failure nor partial necrosis. Functional evaluation beyond six months showed low donor site morbidity and good aesthetic results. CONCLUSION: Immediate vulvar reconstruction with supra-fascial lotus petal flap is a fast, easy and reliable procedure. It enables wide resection and safety margin following tumor removal with free tension suture, good aesthetic results and a favourable functional outcome.