Stefano Gentileschi1, Anna Amelia Caretto2, Maria Servillo2, Gianluigi Stefanizzi3, Caterina Alberti2, Giorgia Garganese4, Simona Maria Fragomeni5, Alex Federico5, Luca Tagliaferri6, Rossana Moroni7, Giovanni Scambia8. 1. Università Cattolica del Sacro Cuore, Dipartimento di Medicina e Chirurgia Traslazionale, L.go Francesco Vito 8, 00168-Roma, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze Della Salute Della Donna E Del Bambino E Di Sanità Pubblica, Unità di Chirurgia Plastica, L.go Agostino Gemelli 8, 00168-Roma, Italy. Electronic address: stefanogentileschi@gmail.com. 2. Università Cattolica del Sacro Cuore, Dipartimento di Medicina e Chirurgia Traslazionale, L.go Francesco Vito 8, 00168-Roma, Italy. 3. Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze Della Salute Della Donna E Del Bambino E Di Sanità Pubblica, Unità di Chirurgia Plastica, L.go Agostino Gemelli 8, 00168-Roma, Italy. 4. Mater Olbia Hospital, Gynecology and Breast Care Center, Strada Statale 125 Orientale Sarda, 07026-Olbia, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità Ginecologia Oncologica, Largo A. Gemelli 8, 00168 Roma, Italy; Università Cattolica del Sacro Cuore, Dipartimento di Scienze della Vita e Sanità Pubblica, L.go Francesco Vito 8, 00168-Roma, Italy. 5. Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità Ginecologia Oncologica, Largo A. Gemelli 8, 00168 Roma, Italy. 6. Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Diagnostica per Immagini Radioterapia Oncologica ed Ematologia, L.go Agostino Gemelli 8, 00168-Roma, Italy. 7. Fondazione Policlinico Universitario A. Gemelli IRCCS, Direzione Scientifica IRCCS, L.go Agostino Gemelli 8, 00168-Roma, Italy. 8. Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Unità Ginecologia Oncologica, Largo A. Gemelli 8, 00168 Roma, Italy; Università Cattolica del Sacro Cuore, Dipartimento di Scienze della Vita e Sanità Pubblica, L.go Francesco Vito 8, 00168-Roma, Italy.
Abstract
INTRODUCTION: Surgical therapy for vulvar cancer involves wide defects that often require flap-based reconstruction. The goal of the reconstruction is fast wound healing with low donor site morbidity. MATERIALS AND METHODS: This is a retrospective observational cohort study in which we reviewed all patients who underwent surgery for vulvar cancer followed by reconstruction using the Superficial Circumflex Iliac Artery Perforator (SCIP) flap between 2015 and 2020. The primary outcome measure of this investigation was the incidence of wound complications. The secondary outcomes were the surgical indications in terms of establishing the anatomical subunits involved in the resection that made us choose this flap for reconstruction. This study adheres to the STROBE guidelines. RESULTS: Thirty-two patients were included; in two cases, the flap was performed bilaterally for a total of 34 SCIP flaps. The mean age of patients was 70.6 ± 8.6 years, and the mean BMI was 26.8 ± 4.7. The SCIP flap was always feasible. The mean flap size was 128.8 ± 74.3cm2. Three patients showed wound complications. In every patient, the defect involved the vulva, perineum and inguinal area; in 18 patients, the mons pubis was also involved. The mean follow-up was 30 months. During the follow-up, six patients died, and four showed local or nodal cancer relapse. CONCLUSION: Our results suggest that the advantages of SCIP flap for the reconstruction of vulvoperineal defects secondary to vulvar cancer surgery include low complication rate, minimal donor site morbidity, quick dissection, proximity of donor and recipient sites, possibility to harvest large skin islands of variable thickness and chimeric flaps.
INTRODUCTION: Surgical therapy for vulvar cancer involves wide defects that often require flap-based reconstruction. The goal of the reconstruction is fast wound healing with low donor site morbidity. MATERIALS AND METHODS: This is a retrospective observational cohort study in which we reviewed all patients who underwent surgery for vulvar cancer followed by reconstruction using the Superficial Circumflex Iliac Artery Perforator (SCIP) flap between 2015 and 2020. The primary outcome measure of this investigation was the incidence of wound complications. The secondary outcomes were the surgical indications in terms of establishing the anatomical subunits involved in the resection that made us choose this flap for reconstruction. This study adheres to the STROBE guidelines. RESULTS: Thirty-two patients were included; in two cases, the flap was performed bilaterally for a total of 34 SCIP flaps. The mean age of patients was 70.6 ± 8.6 years, and the mean BMI was 26.8 ± 4.7. The SCIP flap was always feasible. The mean flap size was 128.8 ± 74.3cm2. Three patients showed wound complications. In every patient, the defect involved the vulva, perineum and inguinal area; in 18 patients, the mons pubis was also involved. The mean follow-up was 30 months. During the follow-up, six patients died, and four showed local or nodal cancer relapse. CONCLUSION: Our results suggest that the advantages of SCIP flap for the reconstruction of vulvoperineal defects secondary to vulvar cancer surgery include low complication rate, minimal donor site morbidity, quick dissection, proximity of donor and recipient sites, possibility to harvest large skin islands of variable thickness and chimeric flaps.