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Lower back defect coverage using a free-style gluteal perforator flap.

Jin Sup Eom1, Joon Pio Hong

  • 1Department of Plastic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 388–1 Pungnap-dong, Songpa-gu, Seoul, South Korea. jinsupp@amc.seoul.kr

Annals of Plastic Surgery
|February 9, 2011
PubMed
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The free-style gluteal perforator flap offers a safe and effective method for reconstructing lower back defects. This technique successfully repaired defects from cancer and surgery, with good long-term outcomes.

Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Dermatologic Surgery

Background:

  • Lower back defects pose significant challenges in reconstructive surgery.
  • Advances in perforator flap techniques have opened new avenues for defect repair.
  • Gluteal perforator flaps offer a promising solution for complex lower back reconstructions.

Purpose of the Study:

  • To evaluate the efficacy and safety of the free-style gluteal perforator flap for lower back defect reconstruction.
  • To assess the outcomes in patients with defects resulting from skin cancer excision or spinal surgery infection.

Main Methods:

  • A free-style gluteal perforator flap was utilized in 10 patients with lower back defects.
  • Flap design was based on perforator detection in the upper parasacral area.

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  • V-Y advancement flaps were used for smaller defects (<6 cm), and rotation flaps for larger defects (>6 cm).

    • Main Results:

    • Successful coverage was achieved in all 10 patients, with primary donor site closure.
    • Four patients experienced complications: partial flap loss (1), venous congestion (2), and hematoma (1).
    • All complications were resolved, with no flap loss during a mean follow-up of 32.4 months.

    Conclusions:

    • The free-style gluteal perforator flap is a safe and effective option for lower back defect reconstruction.
    • This technique provides a relatively easy and reliable method for surgeons.
    • It addresses defects arising from both oncologic resections and post-surgical infections.