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Related Experiment Video

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Perioperative Risk Factors and Long-Term Outcomes Using the Inferior Gluteal Artery Myocutaneous Flap to Reconstruct

Tavis Read1,2, Peter Gearing1, Michael Weymouth1

  • 1Department of Plastic & Reconstructive Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.

Plastic and Reconstructive Surgery
|January 13, 2026
PubMed
Summary

The inferior gluteal artery myocutaneous (IGAM) flap is a safe and effective option for pelvic reconstruction after major surgery. Factors like male sex, smoking, sarcopenia, and recurrent disease are linked to higher complication risks.

Keywords:
FlapIGAMPelvic exenterationPerineal reconstructionSurgery

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Area of Science:

  • Surgical Oncology
  • Reconstructive Surgery
  • Pelvic Surgery

Background:

  • Radical pelvic surgery carries significant perioperative risks.
  • The inferior gluteal artery myocutaneous (IGAM) flap has been developed to improve outcomes in this setting.
  • This study assesses IGAM flap use in pelvic exenteration or abdominoperineal resection.

Purpose of the Study:

  • To evaluate perioperative factors influencing outcomes.
  • To assess flap-specific and donor-site complications.
  • To determine long-term results of IGAM flap reconstruction.

Main Methods:

  • Prospective data collection from 107 adult patients (2013-2025).
  • Analysis of patient demographics, clinical features, and reconstructive characteristics.
  • Primary outcome: flap failure. Secondary outcomes: return to theatre, wound dehiscence, infection, transfusion.

Main Results:

  • Median survival: 68.6 months; 5-year survival: 54.9%.
  • Increased perioperative complications observed in males, smokers, sarcopenic patients, and those with recurrent disease.
  • Sarcopenia significantly increased perioperative complication likelihood (4.9 times, p=0.010).

Conclusions:

  • IGAM flaps offer acceptable complication rates and favorable outcomes for complex perineal reconstruction.
  • Male sex, smoking, sarcopenia, and recurrent disease are associated with poorer perioperative results.
  • The IGAM flap is a valuable reconstructive option for radical pelvic and perineal surgery.