Martius flap is used infrequently by urologists and coloproctologists for repair of fistulae in the perineal region, and is usually missing from the reconstructive palette of plastic surgeons. There is a considerable confusion regarding what the Martius flap contains. It may contain skin, fat, or muscle from the labium major region. In the original description, Heinrich Martius applied the bulbocavernous/bulbospongious muscle for repair of urethra-vaginal fistula. Nowadays, what is known as Martius flap contains the more voluminous labium major fat pad mostly independent of the above muscle. In cadaveric dissections, the labium major fat flap and the bulbocavernous muscle flap is demonstrated as two distinct entities. This way, Martius flap mentioned in the literature is a group of flaps. The history of Martius flap is reviewed, the anatomy is demonstrated on cadaveric dissections, and its clinical application is presented in a case of rectovaginal fistula repair.
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