Flap techniques as an adjunct in vaginal fistulectomy

This paper reviews the method of vaginal fistulectomy as currently practiced worldwide. In addition, the tissue flap techniques available for repair of extensive injuries not amenable to primary multilayer closure are presented. Specific optional flap procedures proposed in fistula closure include: random tissue flaps, the labial fat pad (Martius graft), the bulbocavernosus muscle flap and the gracilis or rectus abdominis myocutaneous tissue flaps. The uses and advantages of each procedure and a comparison with split-thickness skin grafts are discussed.The opinions and assertions contained herein are those of the authors and are not to be construed as official or as representing the views of the Department of the Army or the Department of Defense.