Arch Hand Microsurg 2018; 23(1): 63-67  
Bilateral Vulvar Reconstruction Using Two Different Types of Perforator Flap: A Case Report
Sae Hwi Ki1,2, Seung Hyun Sim2, Sang Hwan Lee2
1Department of Plastic Surgery, Inha University School of Medicine, Incheon, Korea
2Department of Plastic Surgery, Inha University Hospital, Incheon, Korea
Correspondence to: Sae Hwi Ki
Department of Plastic Surgery, Inha University Hospital, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea
TEL: +82-32-890-3870, FAX: +82-32-890-2918, E-mail: mdki1967@gmail.com, ORCID: http://orcid.org/0000-0001-9194-9681
Received: September 18, 2017; Revised: November 6, 2017; Accepted: November 7, 2017; Published online: March 1, 2018.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
We reconstructed an extensive vulvar defect with the internal pudendal artery and the anterior obturator artery perforator flap and compared the two types of flaps. A 57-year-old female patient had a 15×13 cm2 defect on both sides around the vagina after vulvectomy. Due to the injury in the internal pudendal artery, we used the internal pudendal artery perforator on the right side, and the anterior obturator artery perforator flap on the left side. The internal pudendal artery perforator flap could be rotated easily 120 degrees toward the vulvar defect. However, as the anterior obturator artery perforator flap was difficult to rotate, reconstruction was performed by rotation and advancement. The anterior obturator artery perforator flap is a viable alternative method that can be used when it is difficult to use the internal pudendal artery perforator flap during vulvar reconstruction.
Keywords: Vulvar neoplasms, Perforator flap, Rotation


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