Reconstruction of the pelvic floor and perineum with human acellular dermal matrix and thigh flaps following pelvic exenteration

Hakim K. Said, Michael Bevers, Charles E. Butler

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Background: Patients who undergo pelvic floor resection as treatment for recurrent cancer following radiation therapy have increased rates of complications, particularly if permanent prosthetic mesh is used for reconstruction. Human acellular dermal matrix (HADM), commonly used for reconstruction in other torso locations, is associated with lower rates of complications (including infection, adhesions and cutaneous exposure) than synthetic mesh. We describe an effective technique to reconstruct the pelvic floor and perineum with HADM and thigh-based flaps following pelvic exenteration and radical vulvectomy. Case: A 75-year-old woman underwent radical resection of the pelvic floor and perineum to treat recurrent vulvar squamous cell carcinoma and osteoradionecrosis. The pelvic floor and perineal soft tissue defect were reconstructed with HADM (AlloDerm; LifeCell Corporation, Branchburg, NJ) and bilateral, thigh-based tissue flaps, respectively. Despite a large resection, previous irradiation therapy and bacterial contamination the wounds healed without complications. Conclusion: Reconstruction of pelvic floor defects using HADM is an option when wound conditions are unfavorable for the use of permanent prosthetic meshes.

Original languageEnglish (US)
Pages (from-to)578-582
Number of pages5
JournalGynecologic oncology
Volume107
Issue number3
DOIs
StatePublished - Dec 2007

Keywords

  • Alloderm
  • Biocompatible materials
  • Bioprosthetic mesh
  • Carcinoma
  • Gracilis
  • Hernia
  • Osteoradionecrosis
  • Pelvic exentration
  • Pelvic floor
  • Perineum
  • Polypropylenes
  • Posterior thigh
  • Prostheses and implants
  • Radiotherapy
  • Reconstructive surgical procedures
  • Squamous cell
  • Surgical flaps
  • Surgical mesh
  • VRAM

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

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