Discussion Of Strategies To The Plastic And Reconstruction Of Perineal Scar

Objectives:To summarize and compare the different plastic and reconstructive surgical techniques of perineal scar, and to discuss the best surgical approaches for different types of perineal scar.Methods:69patients who consulted the department of Burns and Reconstructive Surgery, Xiangya Hospital because of perineal scar from January1997to January2013were reviewed.40patients were peripheral scar,16patients were central scar and13patients were combined scar.50patients perineal scar received plastic surgery by skin grafts (34of which were peripheral type,10of which were central type and6of which were combined type);9by local flaps (2of which were peripheral type,5of which were central type and2of which were combined type);8by pedicle groin flap (3of which were peripheral type, and5of which were combined type) and2by tissue expansion (1of which were peripheral type,1of which were central type). Post-operative complications, duration of hospital stay, etc. were identified, and different reconstruction techniques were descriptive compared.Results:50patients perineal scar received plastic surgery by skin grafts, and reconstructive the minimum size of wound was8cm×5cm, and the maximum size of wound was35cmx25cm.8cases were partially erosion postoperatively, tips of2cases which assisting by local flaps were discoloration postoperatively and all wounds were healed by dressing.9patients perineal scar received plastic surgery by local flaps, and reconstructive the maximum size of wound was10cm×8cm.1case of wound dehiscence after restore and followed by split-thickness skin graft and all flaps survived.8patients perineal scar received plastic surgery by groin pedicle flaps, and reconstructive the minimum size of wound was18cm×7cm, and the maximum size of wound was15cm×10cm. All flaps were survival.2patients perineal scar received plastic surgery by tissue expansion and no post-operative complications. By comparing the numbers of different types of surgery, skin gfafts was more preference type of surgery in peripheral type, and pedicle flaps were less contractured.Conclusions:The chosen of plastic and reconstructive surgical techniques of perineal scar should be based on the scar area, age and overall general situation. Current skin grafts are still the main method of plasty of perineal scar. If the local skin is not injured, pedicle flap transplantation is the preferred method.