[Repair of soft tissue defect caused by resection of sacral tumors]

To study the therapeutic effect of combining vacuum sealing drainage (VSD) with gluteus maximus myocutaneous flap on the repair of soft tissue defect caused by the resection of sacral tumors.

From June 2007 to June 2008, 6 patients with skin and soft tissue necrosis in the sacrococcygeal region, deep infection, and formation of cavity at 3-6 weeks after sacral tumors resection were treated. There were 4 males and 2 females aged 17-51 years old. The size of skin and soft tissue defects ranged from 15 cm x 11 cm x 6 cm to 20 cm x 18 cm x 7 cm. Every patient underwent VSD treatment for 7-10 days, and the recombinant bovine bFGF was injected into the wound intermittently for 7-14 days (250-300 U/cm2 once, twice daily). The wound was repaired by either the gluteus maximus myocutaneous flap (5 cases) or the lumbar-gluteus flap (1 case), and those flaps were 9 cm x 9 cm-20 cm x 18 cm in size. The donor site were sutured or repaired with split-thickness skin graft.

All the flaps survived uneventfully. The wound healed by first intention in 5 cases, but 1 case suffered from fat liquefaction 2 weeks after operation and healed after drainage and dressing change. All the donor sites healed by first intention, and all the skin grafts survived uneventfully. All the patients were followed up for 6-10 months, there was no relapse of sacral tumor, and the flaps showed no obvious swelling with good color and elasticity.

With fewer complications, the combination of VSD and gluteus maximus myocutaneous flap is a safe and reliable operative method for repairing the skin and soft tissue defects caused by the resection of sacral tumors.