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Vaginal construction with skin grafts and vacuum-assisted closure.

Journal article
Authors Håkan Hallberg
Hans Holmström
Published in Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi
Volume 37
Issue 2
Pages 97-101
ISSN 0284-4311
Publication year 2003
Published at Institute of Surgical Sciences, Department of Plastic Surgery
Pages 97-101
Language en
Links www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Adolescent, Drainage, instrumentation, Equipment and Supplies, Female, Humans, Reconstructive Surgical Procedures, instrumentation, methods, Skin Transplantation, methods, Surgical Sponges, Vacuum, Vagina, abnormalities, surgery, Vaginal Diseases, congenital, surgery
Subject categories Plastic surgery

Abstract

Probably the most common method of constructing a vagina in patients with the Mayer-Rokitansky-Küster syndrome is the technique popularised by McIndoe and Banister in 1938. A cavity is created between the rectum and urethra-bladder complex and is lined with split-thickness skin grafts. One of the disadvantages of using split-thickness skin grafts is the incidence of late contraction of the neovagina. To avoid this problem full-thickness skin grafts have been used, but their take is less reliable. A new technique to improve the take of skin grafts is the VAC-system (vacuum assisted closure, KCI) which has proved to be particularly valuable in grafting difficult anatomical sites. We have used the VAC-system in the construction of a vagina in one case with split-thickness skin grafts and in two cases with full-thickness skin grafts. In all three cases the take was excellent with little discomfort for the patients. It was not necessary to stent the neovagina in the postoperative period and coitus was possible within a month of operation.

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