{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T19:42:20Z","timestamp":1785613340440,"version":"3.56.0"},"reference-count":10,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2022,4,20]],"date-time":"2022-04-20T00:00:00Z","timestamp":1650412800000},"content-version":"vor","delay-in-days":2057,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2016,9,21]],"date-time":"2016-09-21T00:00:00Z","timestamp":1474416000000},"content-version":"tdm","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["www.e-aps.org"],"crossmark-restriction":true},"short-container-title":["Arch Plast Surg"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:p>\nBackground  Perineal defects are commonly encountered during the treatment of conditions such as malignancy, infectious disease, and trauma. Covering large defects in the perineal area is challenging due to its complicated anatomy and the need for functional preservation.<\/jats:p><jats:p>\nMethods  Fourteen patients who underwent reconstructive surgery with multiple perforator flaps for defects &gt;100 cm2 in the perineal area were included in this retrospective cohort study. Characteristics of the perforator flap operation and postoperative outcomes were reviewed.<\/jats:p><jats:p>\nResults  Reconstruction was performed using 2 perforator flaps for 13 patients and 3 perforator flaps for 1 patient. Internal pudendal artery perforator flaps were mainly used for covering the defects. The average defect size was 176.3\u00b161.8 cm2 and the average size of each flap was 95.7\u00b131.9 cm2. Six patients had minor complications, such as wound dehiscence and partial necrosis of the flap margin, which were corrected with simple revision procedures.<\/jats:p><jats:p>\nConclusions  Multiple perforator flaps can be used to achieve successful reconstructions of large perineal defects that are difficult to reconstruct with other coverage methods.<\/jats:p>","DOI":"10.5999\/aps.2016.43.5.446","type":"journal-article","created":{"date-parts":[[2016,9,27]],"date-time":"2016-09-27T05:44:10Z","timestamp":1474955050000},"page":"446-450","update-policy":"https:\/\/doi.org\/10.5999\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Reconstruction of Large Defects in the Perineal Area Using Multiple Perforator Flaps"],"prefix":"10.1055","volume":"43","author":[{"given":"Ki Wook","family":"Sung","sequence":"additional","affiliation":[{"name":"Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Jai","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In Sik","family":"Yun","sequence":"additional","affiliation":[{"name":"Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Won","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,4,20]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1308\/rcsann.2013.95.8.539","article-title":"Reconstruction of perineal defects","volume":"95","author":"M Mughal","year":"2013","journal-title":"Ann R Coll Surg Engl"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/00000637-198905000-00010","article-title":"A subcutaneous pedicle flap for perineal reconstruction","volume":"22","author":"S Sakai","year":"1989","journal-title":"Ann Plast Surg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"683e","DOI":"10.1097\/PRS.0000000000000146","article-title":"Perineal perforator-based island flaps: the next frontier in perineal reconstruction","volume":"133","author":"JT Kim","year":"2014","journal-title":"Plast Reconstr Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1055\/s-2006-941721","article-title":"Perforator flaps for perineal reconstructions","volume":"20","author":"NS Niranjan","year":"2006","journal-title":"Semin Plast Surg"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.ygyno.2010.05.007","article-title":"Perineal reconstruction using a bilobed pudendal artery perforator flap","volume":"118","author":"IS Yun","year":"2010","journal-title":"Gynecol Oncol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"e766","DOI":"10.1016\/j.bjps.2010.07.012","article-title":"Perforator flaps: a new option in perineal reconstruction","volume":"63","author":"R Sinna","year":"2010","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/j.urology.2014.06.023","article-title":"Reconstructive strategy and classification of penoscrotal defects","volume":"84","author":"DK Ahn","year":"2014","journal-title":"Urology"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1734","DOI":"10.1016\/j.bjps.2012.04.055","article-title":"Perineal and vaginal wall reconstruction using a combined inferior gluteal and pudendal artery perforator flap: a case report","volume":"65","author":"VJ Schmidt","year":"2012","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/j.urology.2012.01.073","article-title":"Penoscrotal reconstruction with gracilis muscle flap and internal pudendal artery perforator flap transposition","volume":"79","author":"SH Lee","year":"2012","journal-title":"Urology"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1055\/s-0030-1262947","article-title":"Dominance between angiosome and perforator territories: a new anatomical model for the design of perforator flaps","volume":"26","author":"WM Rozen","year":"2010","journal-title":"J Reconstr Microsurg"}],"container-title":["Archives of Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.e-aps.org\/upload\/pdf\/aps-43-446.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.e-aps.org\/journal\/view.php?doi=10.5999\/aps.2016.43.5.446","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.5999\/aps.2016.43.5.446.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T00:08:07Z","timestamp":1650499687000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.5999\/aps.2016.43.5.446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9]]},"references-count":10,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2022,4,20]]},"published-print":{"date-parts":[[2016,9]]}},"URL":"https:\/\/doi.org\/10.5999\/aps.2016.43.5.446","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":[[2016,9]]},"assertion":[{"value":"2016-03-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-08-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-09-21","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-09-15","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}