case_images: PMC10981213_01
case_images: Defects of labia major and perineum after necrotizing fasciitis infection.
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case_images: After 3 weeks of treatment, the patient has large soft tissue defects in the suprapubic region, labia major, and perineum (Figure 1) on the left side, with a diameter of about 15 cm length and about 10 cm wide, which requires another surgical intervention to close them.
case_images: Marking the flap, and two skin perforators of a. pudenda interna.
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case_images: Initially, two skin perforators of a. pudenda interna are identified by a handheld Doppler device, on and around the ischiorectal fossa, which will determine the base of the flap (Figure 2).
case_images: Full raising of the fascio-cutaneous lotus petal flap.
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case_images: The fascia is also incorporated into the flap and is incised along the edges of the flap to the lateral edge of the defect, preserving the two perforators at the base of the flap (Figure 3).
case_images: The clinical picture of the labia major reconstruction with lotus petal flap.
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case_images: Even after the operation, the flap remains well vascularized, which enables satisfactory healing of the wound (Figure 4).
case_images: Flap appearance 6 months post-op.
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case_images: And 6 months after the operation, we see that the reconstruction of the labia major and the perineum with lotus petal flap gives a satisfactory reconstructive and aesthetic result, and is very acceptable by the patient (Figure 5).