Taylor Flap Reconstruction and Its Impact on Healing and Psychological Comfort: A Therapeutic Challenge Incurred within a Developing Country

Abstract

Purpose: The aim of this study was to assess the feasibility and then report the short, medium and long-term results of Taylor flap reconstructions after abdomino-perineal amputation extended to the posterior wall of the vagina, taken by the tumor mass. The abdomino-perineal amputation is burdened with significant morbidity closely related to the inevitable large perineal defect due to wide excision. Hence the importance of pelviperineal filling techniques to facilitate perineal healing and to ensure a better quality of life, especially sexual, in women after posterior colpectomy, instead of a mutilating posterior pelvic exenteration. We describe and analyze below two cases of perineal reconstruction by modified Taylor flap. During 2020, two of our patients underwent rectus abdominis musculocutaneous flap reconstruction pedicled on the inferior epigastric vessels and with a transverse skin paddle, for abdominoperineal amputations performed for malignant melanoma of the anal canal (Fig. 1) and adenocarcinoma of the lower rectum respectively. Our two patients underwent a posterior colpectomy associated with abdominoperineal amputation, which improved the quality of life of the patients, in particular an almost normal sexual activity in the medium and long term. The postoperative follow-up was simple with an average hospital stay of 09 days. Abdominoperineal healing completed with a median of 19.5 days. Unremarkable follow-up with a follow-up of one year. The realization of modified Taylor flaps allowed a complete and fast perineal healing, and a psychological comfort in connection with a satisfactory sexual activity in both patients.