Evaluation of cutaneous sensibility of the internal pudendal artery perforator (IPAP) flap after perineal reconstructions

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author COLTRO, Pedro S. FMUSP-HC
dc.date.issued 2015
dc.identifier.citation Journal of Plastic Reconstructive and Aesthetic Surgery, v.68, n.2, p.252-261, 2015
dc.identifier.issn 1748-6815
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/9246
dc.description.abstract Background: In oncological perineal reconstructions, the internal pudendal artery perforator (IPAP) flap is our flap of choice, supplied by perforator vessels from the internal pudendal artery and innervated by branches from the pudendal nerve and the posterior femoral cutaneous nerve. Data related to the evaluation of its cutaneous sensibility are scarce, discrepant, and subject to methodological criticism. Objective: The objective of this study was to evaluate the cutaneous sensibility of the IPAP flap 12 months after perineal reconstruction and compare it with the preoperative cutaneous sensibility of the gluteal fold (flap donor area). Methods: A prospective study of 25 patients undergoing abdominoperineal excision of rectum (APER) and reconstruction with bilateral VY advancement IPAP flap was conducted. The tactile, pain, thermal, and vibration sensibilities were analyzed in four areas of the gluteal fold preoperatively and in the four corresponding areas of the flap 12 months after surgery. Tactile sensibility was assessed using the Pressure Specified Sensory Device (TM) (PSSD (TM)), which measures the pressure applied to the skin. The other types of sensibility were analyzed using a needle for pain, hot/cold contact for thermal, and a tuning fork for vibration sensibility. Results: A comparison between tactile sensibility thresholds on the gluteal fold preoperatively and on the flap 12 months after surgery showed no statistically significant difference, with p values >0.05 in all four areas evaluated. All patients had preserved pain, thermal, and vibration sensibility in all four areas, postoperatively. Conclusion: In oncological perineal reconstructions after APER, it is expected that the cutaneous sensibility on the IPAP flap be maintained.
dc.language.iso eng
dc.publisher ELSEVIER SCI LTD
dc.relation.ispartof Journal of Plastic Reconstructive and Aesthetic Surgery
dc.rights restrictedAccess
dc.subject Sensory thresholds; Perforator flap; Reconstruction; Perineum; Rectal neoplasms; Anus neoplasms
dc.subject.other extralevator abdominoperineal excision; vulvo-vaginal reconstruction; y advancement flap; gluteal-fold flap; lotus petal; buttock reconstruction; cancer resection; pelvic anatomy; rectal-cancer; experience
dc.title Evaluation of cutaneous sensibility of the internal pudendal artery perforator (IPAP) flap after perineal reconstructions
dc.type article
dc.rights.holder Copyright ELSEVIER SCI LTD
dc.description.group LIM/04
dc.description.group LIM/22
dc.identifier.doi 10.1016/j.bjps.2014.09.049
dc.identifier.pmid 25456285
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author COLTRO, Pedro S.:HC:ICESP
hcfmusp.author FERREIRA, Marcus C.:FM:MCG
hcfmusp.author BUSNARDO, Fabio F.:HC:ICESP
hcfmusp.author OLIVAN, Marcelo V.:HC:ICESP
hcfmusp.author UEDA, Thiago:HC:ICHC
hcfmusp.author GRILLO, Victor A.:HC:PAHC
hcfmusp.author MARQUES, Carlos F.:HC:ICESP
hcfmusp.author NAHAS, Caio S.:HC:ICESP
hcfmusp.author NAHAS, Sergio C.:HC:ICHC
hcfmusp.author GEMPERLI, Rolf:FM:MCG
hcfmusp.origem.id 2-s2.0-84921444360
hcfmusp.origem.id WOS:000348502400024
hcfmusp.publisher.city OXFORD
hcfmusp.publisher.country ENGLAND
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dc.description.index MEDLINE
dc.identifier.eissn 1878-0539
hcfmusp.citation.scopus 5
hcfmusp.citation.wos 5

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