The 8th edition
This edition we pay attention in thre vaginal pocket , packing and drainage system . Since in our technic the anterio vagina wall consists of more graft and posterior wall consist of more flap. So the packing should not be tight to avoid flap necrosis and not too loose to avoid graft lost.We find that thight packing is not so good in our setting because it conpresses the vascular of the posterior flap and cause a lot of flap necrosis then result inadequte depth of neovagina after completely healing. the The concept is that right after operation the pocket will be very swelling in a small cavity , make the pocket thight and result better graft survival.The drain is change from normal Fr12 PVC radivac drain to silicon15 mm fruited drain , so the drain will funtion for all 6 day before we take out the drain. We found that the good fruited drain can make the big change in flap and graft survival because the less correction and hematoma. Furthermore thevaginal pocket is deeper and wider dissected to the Denonvier layer and retroperitoneal pocket that more potential space and give more space than intraperitoneal space.
WE can say that the factor of deep pocket into retroperitoneum,adepockin ang very good drainage is a key of depth success.