The inferior gluteal artery myocutaneous flap with vascularized fascia lata to reconstruct extended abdominoperineal defects

• Published in: Plastic and reconstructive surgery (1963) Vol. 132; no. 5; p. 836e
• Main Authors: Grinsell, Damien G, Morrison, Edwin, Tansley, Patrick D T
• Format: Journal Article
• Language: English
• Published: United States 01.11.2013
• Subjects: Abdominal Wall - pathology; Abdominal Wall - surgery; Aged; Buttocks - blood supply; Buttocks - surgery; Fascia Lata - blood supply; Fascia Lata - surgery; Humans; Male; Perineum - pathology; Perineum - surgery; Reconstructive Surgical Procedures - methods; Rectal Neoplasms - surgery; Surgical Flaps - blood supply; Wounds and Injuries - etiology; Wounds and Injuries - surgery
• ISSN: 1529-4242
• DOI: 10.1097/PRS.0b013e3182a3c0cd

Abdominoperineal resections have evolved to the point where increasing amounts of skin and pelvic floor are removed, resulting in extensive defects. Many patients receive neoadjuvant chemoradiotherapy and may require adjuvant treatment; thus, primary wound healing is essential. Existing reconstructive techniques may be inadequate and predispose to postoperative complications including wound breakdown and perineal herniation. The authors have developed a novel innervated gluteal flap reconstruction with significant advantages, including preservation of abdominal wall integrity, prone harvest, reliable vascularity, bulky volume, and tailored inset. This robust technique addresses all components required for successful perineal reconstruction comprising dead space obliteration, reconstruction and maintenance of perineal floor integrity, and importation of nonirradiated skin to facilitate primary wound healing. Indications can be extended to include reconstruction of the posterior vaginal wall and large sarcoma/sacrectomy defects. Therapeutic, IV.