Pudendal-thigh flap: anatomic basis and application in repairing and reconstructing male perineal region

Abstract

To investigate the anatomic feature of pudendal-thigh flap and to provide anatomic guide for clinical design and application of the flap in repairing and reconstructing male perineal region. The clinical anatomy of blood supply and refluence and nerve innervation of the perineal region in 15 male cadavers (30 sides) were investigated. Then reasonable flaps were designed for male patients needing repair and reconstruction of the perineal regions based on the anatomic findings. Perineal region has adequate arterial blood supply, abundant venous refluence and reliable nerve innervation. The area has multi-source blood supplies: external pudendal artery, anterior cutaneous branches of obturator artery, bole and lateral branch of arteriae scrotales posteriores. The locations of the arteries were mainly uniform in the 30 sides. Three vasoganglion composed by these arteries and their branches connecting superior, central and inferior parts of the flap. In the 23 cases, the largest flap was 17 cm x 9 cm, and the smallest was 8 cm x 5 cm. The flaps survived and recovered well, with perfect appearance and sensation. The patients were all satisfied with the operation results. The pudendal-thigh flap has abundant blood supply. It can be incised conveniently and covers donor sites well. The flap can be used to repair and reconstruct male perineum with ideal appearance and sensation.