Reconstruction of Radiated Gluteal Defects following Sarcoma Resection with Pedicled Sensate Tensor Fascia Lata Flaps

Abstract

Sarcomas of the gluteal region often result in sizable defects following resection that are challenging to reconstruct due to their location, particularly in patients who have received radiation therapy. Reconstruction of these defects has been seldom discussed in the literature. We present two patients with large radiated gluteal defects following sarcoma resection, of which one patient received neoadjuvant radiation and the other received intraoperative radiation therapy. As a result of the resection and radiation, local tissues and recipient vessels were unsuitable for use in reconstruction. A pedicled tensor fascia lata (TFL) flap was therefore performed in both cases, which resulted in durable sensate reconstruction with good functional outcomes and no complications. We believe the pedicled TFL flap represents an important option for the reconstruction of oncologic gluteal defects that provides well-vascularized and sensate tissue from outside the zone of radiation without the need for microsurgical techniques.

Pedicled anterolateral thigh flap transfer for the reconstruction of a large gluteal defect assisted by preoperative computed tomographic angiography and intraoperative indocyanine green angiography: A case report

“…The tensor fascia lata (TFL) myocutaneous flap can be also considered as an efficient alternative as it can also be elevated in the lateral decubitus position (Chao & Kearns, 2015;Muramatsu et al, 2010). However, in the present case, a wide skin paddle was necessary to resurface the defect.…”

Total Gluteal Reconstruction with “IGA-based V–Y Myocutaneous Advancement Flap”

“…The flaps that have been utilized commonly for gluteal defects are tensor fascia lata 3 and anterolateral thigh 4 pedicled flap. The inferior gluteal thigh flaps are traditionally suggested to resurface ischial and trochanteric ulcers 5 and rarely used in resurfacing a part of the gluteal region.…”

Buttock Reconstruction in Sarcoma Surgery: An Esthetic Sigmoidplasty Closure for Large Circular Defects Using Double Opposing Skin Flaps

“…In contrast to reconstruction of a large sacral soft tissue defect, options for reconstruction of a large gluteal soft tissue defect have seldom been discussed in the literature. 11,12 In many of the sacral-area reconstruction cases, the patients are looking for improvement in quality of life, or simply a closed wound situation. However, the scenario we present is for esthetic reconstruction of the gluteal area in very young patients, who expect not only reconstruction, but a good esthetic outcome, in the face of a reconstruction that is sometimes a lot more challenging than what we routinely deal with in the pressure sore scenario.…”