Anal and Perianal Reconstruction using a Bilateral Angel Wing Flap without Temporary Colostomy: A Case Report

Abstract

Anal and perianal defects after tumor resection often result in complicated circular defects, requiring three-dimensional reconstruction techniques to avoid scar contracture and ensure normal anal function. However, skin grafts are unsuitable in this region due to risk of contracture, and flaps such as the V-Y advancement flap, which have been commonly used, are too thick to create a natural structure for the anal sphincter. In this report, we present a case in which a 44-year-old woman underwent a bilateral angel wing flap operation to reconstruct an anal defect after tumor resection without the need for temporary colostomy. This flap formed a natural conduit and a much thinner and more suitable option for the physiologic and natural reconstruction of the anal and perianal region. During long-term follow-up, the patient experienced no complications such as flap necrosis or infection and neither did she have problems with anal function, including incontinence or obstruction of the anal passage. We propose the “angel wing” flap as a probable option for improving the quality of life of patients with anal and perianal defects.