Vulvar reconstruction using a pedicle flap based on the superficial external pudendal artery.

We present a new method for vulvar reconstruction based on recently described vasculature of the lower abdominal skin and subcutaneous tissue. The superficial external pudendal artery supplies the region encompassing the suprapubic and infraumbilical skin. Thus, a pedicled skin flap based on the superficial external pudendal artery is designed in the suprapubic area and rotated into place for vulvar reconstruction. Because of the thickness and pliability of the flap as well as the inconspicuous donor scar, we believe this method of reconstruction to be superior to skin grafts or bulkier (ie, musculo- and fasciocutaneous) tissue flaps.