Reconstruction of posttraumatic perineal defects

ABSTRACT

Posttraumatic perineal defects restrict abduction of the thigh, interfere with sitting, walking, performance of normal excretory and sexual functions and distort the external genitalia. This study evaluates the different methods of reconstruction of perineal defects according to the type of contracture. 24 patients suffering from perineal defect, 16 males and 8 females. Their ages ranged from 6 to 5.8 years with mean of 13.88 years. They underwent reconstruction after releasing of contracture either by skin grafts, Z-plasty or, local flaps from adjacent areas depending on the conditions of the surrounding tissues. In 14 cases release of scar by incision or excision with free skin grafts were carried out, while local flap transfers including skin elongation procedures such as Z-plasty were performed in 5 patients, V-Y plasty in 2 patients and regional flap transfers i.e. pedicled axial local flap transfers were performed in last 3 cases. In this paper, we classify perineal contractures into five types and present our conclusion depending on the criteria for selecting appropriate surgical methods according to contracture types. Our results suggest that there are four key features of surgical methods for perineal reconstruction size; depth; location and shape