For vulvar reconstruction following radical
vulvectomy in a 71-year-old woman with a large
vulvar cancer, we applied the deep inferior epigastric
perforator flap (
DIEP flap), a typical
perforator flap, which could be performed by utilizing an abdominal incision
wound without producing another surgical
scar and had less donor site morbidity because of a minimal sacrifice of muscles. The
surgical procedures were less invasive and simple, and morphologically and functionally satisfactory results were obtained: no recurrence of
cancer, a well-preserved vulvar morphology with less donor site
scarring, and no functional disturbance such as
dysuria and
abdominal hernia. We consider that the
DIEP flap is the first choice for vulvar reconstruction following radical
vulvectomy. Even in radical
vulvectomy without an abdominal incision
wound, the
DIEP flap with an anatomically reliable vascular pedicle can be an effective option.