{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:22:31Z","timestamp":1789690951130,"version":"4.0.1"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T00:00:00Z","timestamp":1651708800000},"content-version":"vor","delay-in-days":2865,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:p>\n          Background  Vulvar defects result chiefly from oncologic resection of vulvar tumors. Reconstruction of vulvar defects restores form and function for the purpose of coitus, micturition, and defecation. Many surgical options exist for vulvar reconstruction. The purpose of this article is to present our experience with vulvar reconstruction.<\/jats:p><jats:p>\n          Methods  From 2007 to 2013, 43 women presented to us with vulvar defects for reconstruction. Their mean age at the time of reconstruction was 61.1 years. The most common cause of vulvar defect was from resection of vulvar carcinoma and extramammary Paget's disease of the vulva. Method s of reconstruction ranged from primary closure to skin grafting to the use of pedicled flaps.<\/jats:p><jats:p>\n          Results  The main complications were that of long term hypertrophic and\/or unaesthetic scarring of the donor site in 4 patients. Twenty-two patients (51%) were able to resume sexual intercourse. There were no complications of flap loss, wound dehiscence, and urethral stenosis.<\/jats:p><jats:p>\n          Conclusions  We present a subunit algorithmic approach to vulvar reconstruction based on defect location within the vulva, dimension of the defect, and patient age and comorbidity. The gracilis and gluteal fold flaps are particularly versatile and aesthetically suited for reconstruction of a variety of vulvar defects. From an aesthetic viewpoint the gluteal fold flap was superior because of the well-concealed donor scar. We advocate the routine use of these 2 flaps for vulvar reconstruction.<\/jats:p>","DOI":"10.5999\/aps.2014.41.4.379","type":"journal-article","created":{"date-parts":[[2014,7,25]],"date-time":"2014-07-25T01:05:25Z","timestamp":1406250325000},"page":"379-386","source":"Crossref","is-referenced-by-count":35,"title":["Subunit Principle of Vulvar Reconstruction: Algorithm and Outcomes"],"prefix":"10.1055","volume":"41","author":[{"given":"Bien-Keem","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin Chun-Wui","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eng Hseon","family":"Tay","sequence":"additional","affiliation":[{"name":"Thomson Women Cancer Centre, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong Chen","family":"Por","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,5,5]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/S1470-2045(08)70147-5","article-title":"Vulvovaginal reconstruction for neoplastic disease","volume":"9","author":"M Hockel","year":"2008","journal-title":"Lancet Oncol"},{"key":"ref2","first-page":"292","article-title":"Vulvar cancer: what do we know about our patients?","volume":"42","author":"N Shamini","year":"2001","journal-title":"Singapore Med J"},{"key":"ref3","first-page":"4","article-title":"Extramammary Paget disease: immunohistochemistry is critical to distinguish potential mimickers","volume":"18","author":"EC Wang","year":"2012","journal-title":"Dermatol Online J"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/0002-9378(68)90508-5","article-title":"Treatment of intraepithelial carcinoma of the vulva by skin excision and graft","volume":"102","author":"F Rutledge","year":"1968","journal-title":"Am J Obstet Gynecol"},{"key":"ref5","first-page":"193","article-title":"Plastic management of extensive vulvar defects","volume":"38","author":"CG Julian","year":"1971","journal-title":"Obstet Gynecol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1097\/00006534-198904000-00018","article-title":"A new technique of vaginal reconstruction using neurovascular pudendal-thigh flaps: a preliminary report","volume":"83","author":"JT Wee","year":"1989","journal-title":"Plast Reconstr Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/00006534-198707000-00015","article-title":"A fasciocutaneous flap for vaginal and perineal reconstruction","volume":"80","author":"TN Wang","year":"1987","journal-title":"Plast Reconstr Surg"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1097\/00006534-197608000-00006","article-title":"Vaginal reconstruction with gracilis myocutaneous flaps","volume":"58","author":"JB McCraw","year":"1976","journal-title":"Plast Reconstr Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1097\/00006534-199502000-00018","article-title":"Short gracilis myocutaneous flaps for vulvoperineal and inguinal reconstruction","volume":"95","author":"SH Chen","year":"1995","journal-title":"Plast Reconstr Surg"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1111\/j.1471-0528.1990.tb02475.x","article-title":"The use of rectus abdominis myocutaneous flaps following excision of vulvar cancer","volume":"97","author":"JH Shepherd","year":"1990","journal-title":"Br J Obstet Gynaecol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1998","DOI":"10.1097\/00006534-200112000-00025","article-title":"The gluteal-fold flap for vulvar and buttock reconstruction: anatomic study and adjustment of flap volume","volume":"108","author":"I Hashimoto","year":"2001","journal-title":"Plast Reconstr Surg"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1097\/01.prs.0000227683.47836.28","article-title":"Gluteal fold V-Y advancement flap for vulvar and vaginal reconstruction: a new flap","volume":"118","author":"PK Lee","year":"2006","journal-title":"Plast Reconstr Surg"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.5999\/aps.2014.41.4.379.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T23:15:20Z","timestamp":1651792520000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.5999\/aps.2014.41.4.379"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7]]},"references-count":12,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2022,5,5]]},"published-print":{"date-parts":[[2014,7]]}},"URL":"https:\/\/doi.org\/10.5999\/aps.2014.41.4.379","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2234-6163","2234-6171"],"issn-type":[{"value":"2234-6163","type":"print"},{"value":"2234-6171","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,7]]}}}