{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:48:37Z","timestamp":1778154517188,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T00:00:00Z","timestamp":1587945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Reconstruction following total vulvectomy is a reconstructive challenge. Previously described techniques typically require bilateral flaps and the associated donor site morbidity. We present a case of reconstruction after radical total vulvectomy using a single split anterolateral thigh (ALT) perforator flap with a design that optimizes perfusion while allowing for primary donor site closure. A 68\u2010year\u2010old female with a history of vulvar squamous cell carcinoma who had previously undergone vulvectomy and radiation therapy presented with local recurrence. The patient required a radical total vulvectomy, resulting in a 12\u2009\u00d7\u200910 cm vulvar defect. A 2\u2010perforator ALT flap (25\u2009\u00d7\u20097 cm) was harvested, split transversely, and then inset in a circumferential manner around the vulva. This approach contrasts with previous reports, which split the ALT flap longitudinally or centrally, and can compromise perfusion and\/or preclude primary donor site closure. The patient healed without complication with 6 months of follow\u2010up. The described approach allows for total vulvectomy reconstruction using a single ALT flap with a perforator configuration that maximizes perfusion while obviating the need for donor site grafting.<\/jats:p>","DOI":"10.1002\/micr.30592","type":"journal-article","created":{"date-parts":[[2020,4,27]],"date-time":"2020-04-27T19:54:46Z","timestamp":1588017286000},"page":"70-74","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Reconstruction of a radical total vulvectomy defect with a single split anterolateral thigh perforator flap: A case report and review of the literature"],"prefix":"10.1002","volume":"41","author":[{"given":"Andrew L.","family":"O'Brien","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Jadallah","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7536-0989","authenticated-orcid":false,"given":"Albert H.","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,4,27]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2013.10.037"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24233"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22498"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/229255031202000103"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000765"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2019\/e1218"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2005.05.009"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30077"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001445"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181c495ed"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gore.2018.08.007"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000008"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31822b6b87"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2015.01.526"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2013.09.014"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000001103"},{"key":"e_1_2_4_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anplas.2018.03.007"},{"key":"e_1_2_4_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31819e2718"},{"key":"e_1_2_4_20_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21551"},{"key":"e_1_2_4_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2019.04.012"},{"key":"e_1_2_4_22_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2014.41.4.379"},{"key":"e_1_2_4_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-197907000-00022"},{"key":"e_1_2_4_24_1","article-title":"Reconstruction of a large pelvic defect by transfer of a quadruplet combination of pedicled flaps from the medial thigh using bilateral muscular gracilis flaps and bilateral vertical posteromedial thigh (vPMT) propeller flaps\u2010a case report","volume":"5","author":"Wishart K. 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