A Novel Technique for Reconstruction After Abdominoperineal Resection: V-Y Partially De-epithelized Turnover Flap with Its Own Inherent Mesh-A Three-Case Report

The main goal in reconstructions of the pelvic base after abdominoperineal resection is to close the defect with a well-vascularized tissue and prevent herniation by providing sufficient perineum support. Neoadjuvant radiotherapy generally leads the surgeon to distant muscle flap options; however, in the absence of radiation history, the use of local flaps is reasonable if they are of sufficient quality. In this article, we present the use of a V-Y partially de-epithelized turnover flap, a modification of the V-Y advancement flap, with perineal repair accomplished through a mesh flap of dermis, eliminating the requirement for a biologic mesh. We think that our modified flap adequately supported the perineal floor by utilizing a well-vascularized dermal mesh flap and provided a tension-free closure by filling up the dead space using a partial turnover maneuver.