ORIGINAL RESEARCH article

Front. Surg.

Sec. Reconstructive and Plastic Surgery

Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1571769

This article is part of the Research TopicRecent Advancements and New Developments in Reconstructive SurgeryView all articles

A Novel Approach Using the Five-Flap Technique for Posterior Fourchette Reconstruction: A Clinical Study Addressing Flap Deformity and Sexual Dysfunction

Provisionally accepted
Yilin  LiYilin LiMeichen  LiuMeichen LiuYu  ZhouYu ZhouYujiao  CaoYujiao CaoFengyong  LiFengyong Li*
  • Plastic Surgery Hospital (PSH), Chinese Academy of Medical Sciences andPeking Union Medical College, Beijing, China

The final, formatted version of the article will be published soon.

To evaluate the clinical efficacy of the five-flap technique in the reconstruction of posterior fourchette flap deformities.A retrospective analysis was conducted on 36 patients with posterior fourchette flap deformities who underwent surgery using the five-flap technique. Preoperative and postoperative pain scores, sexual function scores, and vulvar aesthetic scores were recorded. Additionally, the degree of sexual function improvement and the incidence of complications were assessed. Depending on the distribution of the data, paired t-tests or non-parametric tests were employed to compare preoperative and postoperative scores. Descriptive statistics summarized the distribution of sexual function improvements and complications.The study demonstrated a significant reduction in postoperative pain scores (preoperative: 1.5 [0, 2] vs. postoperative: 0 [0, 1], p = 0.001). Sexual function scores improved from 19.939 ± 3.903 to 28.742 ± 2.766 (p = 0.019), while aesthetic scores increased from 10.50 (9, 12.75) to 21.72 (20.25, 23) (p < 0.001). Based on the definition of sexual function improvement (significant improvement, moderate improvement, no improvement), 72.2% of patients experienced significant improvement, 25.0% moderate improvement, and only 2.8% showed no improvement.Furthermore, no cases of flap necrosis or recurrence were observed. The complication rate was low, with only one case (2.8%) of mild infection and two cases (5.6%) of scar tension, all of which resolved well with local treatment.The five-flap technique is a safe and effective innovative reconstructive method that demonstrates significant pain relief, sexual function improvement, and aesthetic enhancement in the treatment of posterior fourchette flap deformities. With a low complication rate, it provides a personalized treatment option for complex vulvar deformities.

Keywords: Posterior fourchette, Five-flap technique, Sexual function improvement, Vulvar aesthetic reconstruction, Flap deformities

Received: 06 Feb 2025; Accepted: 16 Apr 2025.

Copyright: © 2025 Li, Liu, Zhou, Cao and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Fengyong Li, Plastic Surgery Hospital (PSH), Chinese Academy of Medical Sciences andPeking Union Medical College, Beijing, China

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