Gluteal fold flaps for perineal reconstruction.

Area of Science:

• Surgical Oncology
• Plastic and Reconstructive Surgery
• Gynaecology
• Urology
• Colorectal Surgery

Background:

• Perineal defects commonly result from ablative cancer surgeries.
• Reconstruction of these defects is crucial for patient recovery and quality of life.
• The gluteal fold flap has emerged as a potential solution for complex perineal reconstructions.

Purpose of the Study:

• To evaluate the efficacy and outcomes of gluteal fold flaps in perineal defect reconstruction.
• To identify factors influencing healing time and patient discharge.
• To present a management algorithm for post-tumor resection perineal defects.

Main Methods:

• Retrospective review of case notes for patients undergoing gluteal fold flap reconstruction.
• Analysis of 127 gluteal fold flaps used for 77 perineal defects between 2007-2010.
• Assessment of patient discharge times, healing times, flap success rates, and complication rates.

Main Results:

• High flap success rate (97.6%) with 124 successful flaps.
• Most patients discharged within one month (90%), with a mean discharge time of 13.2 days.
• Factors like pre-operative radiotherapy, patient comorbidities, and anus resection prolonged healing times.
• Wound breakdown was the most common complication (30% of patients).

Conclusions:

• The gluteal fold fasciocutaneous flap is a versatile and reliable option for perineal defect reconstruction.
• Patient comorbidities, prior radiotherapy, and anus resection are associated with longer healing periods.
• An algorithm for managing perineal defects post-tumor resection is presented.