Figure 2.

Vertical rectus abdominis myocutaneous (VRAM) flap reconstruction of the perineum after abdominoperineal resection in a man with locally advanced rectal cancer that invaded through the perineal skin. The patient received neoadjuvant chemoradiation therapy. (A) Pictures show preoperative markings. (B) Intraoperative perineal defect. (C) Immediate postoperative flap reconstruction. (D) 6-week follow-up. Photographs courtesy of Susan M. Pike, M.D., Plastic and Reconstructive Surgery, Scott & White University Medical Campus, Round Rock, TX.