Sub-regional skin grafting for perineal resurfacing after excision of superficial vulvar tumors: An excellent method to achieve an aesthetically pleasing appearance.

ABSTRACT

OBJECTIVE: To investigate the effect of sub-regional split-thickness skin grafting in perineal resurfacing. METHODS: A single-center retrospective study was conducted in the Genital Plastic Surgery Center. Detailed clinical data of 14 consecutive patients who underwent split-thickness skin grafting after vulvar tumor resection from February 2013 to June 2022 were analyzed. Clinical data, postoperative photographs, scoring of vulvar appearance, and questionnaire results of the Female Sexual Function Index before and after surgery were analyzed. RESULTS: The patients had sub-regional split-thickness skin grafting ranging from 7 × 8 cm to 11 × 12 cm (88.86 ± 24.99 cm2 ). After a follow-up of 8.21 ± 2.22 months (mean ± SD), all patients had a three-dimensional and aesthetically pleasing vulva and high scoring of vulvar appearance (mean ± SD, 4.43 ± 0.65). All patients had good healing of both the recipient and donor sites without major complications. Only one patient had minor dehiscence in the perineal region and recovered soon after proper treatment. The scores of the Female Sexual Function Index were significantly improved after surgery. Among the included domains, scores of "desire," "arousal," "orgasm" and "satisfaction" increased significantly after surgery (p value <0.05). CONCLUSIONS: Sub-regional split-thickness skin grafting could achieve excellent cosmetic outcomes with few complications in perineal reconstruction after the excision of superficial vulvar tumors. It can provide an aesthetically pleasing appearance in the vulvar region and improve female sexual function to some extent. In general, sub-regional split-thickness skin grafting could be a recommended reconstructive option to repair vulvar defects.