PMC3635689_01
a The 10 x 8 cm tumor was exposed on the suture line, surrounded by complicated phlegmonous inflammation. b The large perineal defect after TPE with partial sacrectomy.
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F1
A narcotic analgesic was administered to address the pain (fig. 1a). The tumor and tissue damaged by irradiation was resected during partial sacrectomy (fig. 1b).
a Design of the V-shaped skin incision for the V-Y advancement flap. b Both flaps were advanced toward the midline.
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F2
A bilateral V-shaped incision was made in the skin (fig. 2a). The bilateral flaps were advanced toward the midline and sutured in the following three layers: the muscle, the fasciosubcutaneous tissue and the skin (fig. 2b).
a Completion of the V-Y-shaped reconstruction. b Findings 4 months after surgery.
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F3
The large defect was closed using a V-Y-shaped reconstruction without tension (fig. 3a). There were no late complications such as pelvic collection, perineal wound dehiscence or lower limb weakness after 1 month (fig. 3b).