Gracilis Flap for Vaginal Reconstruction

Abstract

Reconstruction of the vagina is performed for patients undergoing abdominoperineal resection, pelvic exenteration for cancer involving the cervix, vagina, or rectum, and other causes of acquired pelvic defects. Immediate reconstruction after partial or total vaginal resection facilitates primary healing of the perineal defect, decreases fluid loss from the pelvis, reduces infection rate, and decreases nutritional demands. The gracilis flap is one of the most commonly used flaps for reconstruction of these challenging pelvic defects because it is versatile, has minimal donor side morbidity, and often lies outside the field of radiation. This chapter provides a detailed account of patient assessment and operative techniques.