Spatial W-plasty full-thickness skin graft for neovaginal reconstruction.

Although neovaginal reconstruction has achieved satisfactory results, there is still room for refinement and improvement. Despite its popularity, McIndoe's inlay split-thickness skin graft method still has several significant drawbacks. Here a new approach to neovaginal reconstruction by using a full-thickness skin graft displayed in the fashion of spatial W-plasty is described. Our idea combines the advantages of a full-thickness skin graft and Z-plasty principle in clinical practice. Four patients who had been reconstructed with this method had satisfactory results with minimal secondary contracture and unilateral linear groin scar. Three of them have married and enjoy sexual life without difficulties. The fourth patient has not married but shows no contracture in follow-up examinations. Since the result is encouraging, this method deserves wider clinical application.