Pelvic floor replacement

Reconstructive surgery of the pelvic floor has rapidly evolved over the last decades. Although many modern surgical procedures have been described, due to the particular demands of the pelvic region it still remains a big challenge for the plastic surgeon with the goal of an optimal shape, function and aesthetics. The best results can be achieved if a thoroughly planned interdisciplinary concept including the plastic surgeon is prospectively chosen. In principal all forms of defect coverage available in plastic surgery are possible. The selection of the reconstructive procedure should be oriented to the treatment algorithm of the “reconstructive ladder”, which should be an orientation for the surgeon in order to achieve a rapid restoration of the function of the pelvic floor and at the same time permit fast wound healing. The aesthetic reconstruction of the shape of the body surface and the genitalia are also extremely important. Perforator-based flaps from the medial thigh are nowadays a safe option for the reconstruction. For larger defects the best treatment options for coverage are still the rectus abdominis flap, the deep inferior epigastric perforator (DIEP) flap and the gluteus maximus flap. When deciding on the surgical procedure, estimation of the morbidity of the residual flap defect plays an important role. © 2018, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.