Rectus Abdominis Myocutaneous Flap and its Modifications in Perineal and Vulva Reconstruction: a Case Series Analysis

The study aims to investigate the effect of racket-shaped upper rectus abdominis myocutaneous flap in perineal reconstruction following vulvar cancer. The clinical data of 18 patients who underwent perineal reconstruction after vulvar tumor resection from January 2009 to July 2022 in the Genital Plastic Surgery Center were retrospectively analyzed. All patients were consecutively included, and no patients were excluded. The included eighteen patients underwent vulvar reconstruction with the racket-shaped upper rectus abdominis myocutaneous flap. The size of the racket-shaped upper rectus abdominis myocutaneous flap in the 18 patients ranged from 6 × 10 to 17 × 18 cm. During the follow-up of 7–10 months, all the included patients had well-surviving flaps and esthetically pleasing appearance in the perineal region without major complications. Only two patients had minor dehiscence, and it recovered soon after proper treatment. When approaching perineal wound reconstruction, the racket-shaped upper rectus abdominis myocutaneous flap can achieve a non-bulky and esthetically pleasing vulvar appearance with few complications. In general, it is a reliable way to get the ideal reconstruction.