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Pre-Conference Workshop - Beyond the Basics: Navig ...
Autologous and Vaginal Flaps
Autologous and Vaginal Flaps
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Pdf Summary
The document discusses the use of flaps in complex vaginal reconstruction, highlighting the increasing need due to women living longer, a projected increase in women over 60, and a growing interest in maintaining self-image and sexual health beyond menopause. The prevalence of pelvic floor diseases, which increase with age and parity, drives this demand.<br /><br />The document emphasizes the importance of evaluation and surgical planning, including assessing risk factors, prior surgeries, co-morbid conditions, and tissue quality. It discusses the physical exam and tests necessary for effective planning and details various surgical considerations, particularly focusing on the location and size of the defect, tissue quality, and surgical approach.<br /><br />Different types of flaps are explained, including vaginal, labial, peritoneal, and inner thigh flaps. Each flap type has specific indications, advantages, and techniques for harvest and application. For instance, the Martius flap, derived from fibrofatty labial tissue, is known for its reliability and versatility in promoting neovascularity and filling dead space, making it suitable for a range of vaginal reconstruction needs.<br /><br />The document also presents the vascular anatomy relevant to flap harvesting, underlining the importance of understanding blood supply in flap viability. Patient counseling about the potential need for long-term catheter use, cosmetic and functional outcomes, and possible recurrence or complications is emphasized as a crucial part of pre-surgical preparation.<br /><br />Key takeaway points include the rising demand for complex vaginal reconstruction, the critical nature of pre-surgical planning, and the availability of various flaps, allowing most repairs using native tissue without needing a plastic surgeon.
Keywords
vaginal reconstruction
flaps
pelvic floor diseases
surgical planning
tissue quality
Martius flap
vascular anatomy
patient counseling
self-image
sexual health
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