PMC5853016_01
(a) Preoperative view of Case 1. A 1.5 cm x 1.5 cm ulcer was noted between the anus and vagina. (b) After debridement, a bilobed flap was elevated from the left gluteal lesion. (c) The large flap was transposed to cover the perineal skin defect, and the small flap was transposed to cover the donor site of the large flap. (d) Six-month postoperative view. The viability of the flap was favorable, and it divided the anus and vagina. (e) Six-month postoperative image showing favorable bowel control
AJPS-14-15-g002.jpg
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F2
On examination, a 1.5 cm x 1.5 cm ulcer was found between the anal and vagina [Figure 2a]. A bilobed perforator flap was elevated from the left gluteal lesion and rotated toward the skin defect [Figure 2b and c]. She also gained favorable bowel control [Figure 2d and e].
PMC5853016_02
(a) Preoperative view of Case 2. A 1.0 cm x 1.5 cm ulcer was noted in the perineal lesion (arrow). (b) The ulcer was excised completely, and a bilobed perforator flap was designed. (c) Intraoperative view of flap transfer. The large flap was transposed to cover the perineal defect, and the small flap was transposed to cover the donor site of the large flap. (d) Three-month postoperative image showing a favorable appearance
AJPS-14-15-g003.jpg
PMC5853016_02_AJPS-14-15-g003.jpg
F3
On examination, a 1.0 cm x 1.5 cm ulcer was found in the perineal area [Figure 3a]. The ulcer was excised completely, and the skin defect was reconstructed with a bilobed perforator flap [Figure 3b and c].