MYOCUTANEOUS FLAPS IN GENITOURINARY ONCOLOGY

Between January 1983 and September 1992, 32 myocutaneous flaps were fa shioned in 28 patients for reconstruction following treatment of genit ourinary malignancies or complex pelvic fistulas. Of the myocutaneous flaps 14 were used to obtain primary soft tissue coverage of large but otherwise uncomplicated wounds and 10 were used to cover previously i rradiated resection sites. Four myocutaneous flaps were used to repair complex radiation-induced fistulas involving the bladder, vagina, ure thra and rectum. Flaps were used to cover infected or nonhealing open wounds in 8 cases, 4 of which also had been previously irradiated. Myo cutaneous flap donor sites were the tenser fascia lata in 11 cases, gr acilis in 9, rectus abdominis in 10 and rectus femoris in 2. There was 1 major complication (flap loss) and 9 minor complications. There wer e no perioperative deaths. Myocutaneous flaps are an effective means o f covering large groin, perineal and lower abdominal surgical defects after radical surgery.