Superior and inferior gluteal artery perforator flaps in reconstruction of gluteal and perianal/perineal hidradenitis suppurativa lesions

Abstract

Patients with gluteal and perineal/perianal hidradenitis suppurativa are usually neglected by surgeons because of lack of collaboration of general and plastic surgery departments. Most surgical treatment options described in the literature such as secondary healing after excision and skin grafting prevent patients from returning to daily life early, and cause additional morbidities. Fasciocutaneous flaps other than perforator flaps may be limited by design such that both gluteal regions may have to be used for reconstruction of large defects. SGAP and IGAP flaps have long pedicles with a wide arc of rotation. Large defects can be reconstructed with single propeller flap designs, enabling preservation of the rest of the perforators of the gluteal region.

Divisional Reconstruction Strategy: The Repair of Perineal Skin Defect After Tumor Resection

“…In 1993, they described the application of anterolateral thigh perforator flap (13). The application of perforator flap in the perineum was explored and widely used since then (14)(15)(16)(17)(18). The blood supply of perforator flap comes from small and perforating branch vessels which go through the deep fascia.…”

Multidimensional Use of Pedicled Gluteal Artery Perforator Flaps in Perianal and Gluteal Regions

“…However disadvantages such as limited flap rotation and sacrificing the muscle may limit the application. After the perforator concept, we think that the SGAP and IGAP flap methods we have used are very useful and practical in repairs of gluteal region defects (7). In all cases, SGAP and IGAP were skeletalized to the segmentary artery.…”

Islanded Perforator Flaps in the Reconstruction of Hidradenitis Suppurativa Defects

“…A variety of techniques, including secondary healing, skin grafts with or without vacuum-assisted closure (VAC) therapy, and local flaps, have been used to close the defects. 18,[20][21][22][23][24][25][26][27][28][31][32][33] Skin grafting after excision of HS provides prompt and simple closure of large defects. However, the results are disfiguring due to color variability, depression, and contractures resulting from the removal of all subcutaneous tissue.…”