GRACILIS MYOCUTANEOUS FLAP TO RECONSTRUCT LARGE PERINEAL DEFECTS

Large perineal defects can occur after surgery for recurrent malignanc y particularly after adjuvant radiotherapy or in complex chronic perin eal inflammatory conditions. Quality of life can be severely impaired by perineal wounds or chronic sinuses. Muscle and myocutaneous flaps c an be used to close large defects, increase vascular supply to poorly healing wounds, and provide bulk for sitting. We report 5 cases where the gracilis flap was used to repair large perineal defects. The defec ts were created after wide perineal excision for recurrent tumours ass ociated with radiation damaged skin (2 cases) and after excision of ch ronic sinuses complicating the perineal wounds after abdominoperineal excision of the anus for inflammatory bowel disease (3 cases).