Case Report: Digital CTA-assisted anterolateral thigh perforator pedicled flap for repairing postoperative defects in Vulvar Paget's disease

Vulvar Paget's disease often requires extensive surgical resection that can result in perineal tissue defects. The anterolateral thigh (ALT) flap is a commonly used reconstructive option; however, anatomical variations in its perforator vessels can present surgical challenges. The study evaluated the role of preoperative digital computed tomographic angiography (CTA) in ALT flap planning. A patient with Vulvar Paget's disease underwent wide local excision followed by reconstruction using an ALT flap. Preoperative CTA with three-dimensional digital reconstruction enabled localization and assessment of the thigh perforator vessels. The flap was harvested and transferred according to the preoperative plan. Postoperatively, the flap demonstrated good perfusion with satisfactory vulvar morphology and functional recovery.