Abstract
Healing after abdominoperineal resection is often difficult especially in patients that have undergone radiation therapy. Furthermore, vaginal reconstruction is an important issue for the women that undergo this surgery. The goal of this work is to describe our surgical technique of perineal reconstructions with Taylor musculocutaneous flaps and provide an overview of its results. The technique consists of drawing a skin paddle from the pit of the scapula to the umbilicus. The skin paddle is then harvested with the rectus abdominis muscle. The muscle insertion on the pubic bone is left intact to prevent any tension on the pedicle. Postoperative care concentrates on surveillance of the coloration of the flap and measures that allow patients to stand up as soon as possible. No pressure on the flap is tolerated for the first three weeks.
Between 2000 and 2010, the 68 patients who underwent reconstruction with a Taylor flap, healed within a median time of 30 days. The reoperation rate was 11.7% including 1 for herniation. The principal causes for delayed healing were wound dehiscence, abscess, and partial necrosis. However, no flaps required removal. The mean duration of hospitalization was 23.7 days.
The localization of the skin paddle in an area were anastomosis between the deep inferior epigastric artery, the superior epigastric artery and the lumbar arteries are very dense offers a reliable blood supply. The muscle harvested makes the flap bulky enough to fill the dead space caused by the abdominoperineal resection. Taylor flaps substantially improve the reconstruction of defects resulting from abdominoperineal resection. They enable complete and rapid healing with low morbidity.
