ANATOMICAL AND SURGICAL RATIONALE OF VULVA PLASTICS

Abstract

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Aim. Improvement of the results of reconstructive plastic surgery with use of displaced skin-fascial flaps for closing wound defects on the female perineum. Material and Methods. The study was performed on 325 objects: 21 corpses of people (women); 304 women, including 102 who studied anatomical parameters of the perineum and 202 patients who underwent surgical interventions on the perineum, followed by the closure of wound defects in various ways. Results and Discussion. A complex of new morphometric data on the structure of the surface tissues of the female perineum was obtained. Data on the variability of anatomical parameters of the female perineum depending on the type of Constitution and body weight are presented. On the basis of anatomical data the model of formation of the moved skin-fascial flap from a back surface of a hip at plastic of wound defects of a crotch is developed. The anatomical parameters of the perineum, allowing to calculate the size of the moved skin-fascial flaps and the probability of necrosis and ischemia of the flaps in the postoperative period, were determined. Identified areas of high risk for suturing tissues and this morphological substantiation of application of surgical and microsurgical operative techniques stitches in different parts of the wound. Conclusions. These studies expand the understanding of anatomy and morphometric characteristics of female perineum tissues and can be used in the planning and individualization of perineal plasty, which improves the long-term results of surgical treatment and the quality of life of patients.