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

Abstract

Introduction A 44-year-old man was presented with chronic discharging multiple perianal fistula and squamous cell carcinoma of the left buttock. Report The patient was subjected to wide local excision of the entire left gluteal and adjacent sacral regions and reconstruction with extended island inferior gluteal artery based V–Y myocutaneous advancement flap. Result and Conclusion Extended island inferior gluteal based V–Y flap can be a good option for extensive defects involving the gluteal region and the sacrum.

Bilateral gluteal reconstruction with deep inferior epigastric perforator flaps and saphenofemoral arteriovenous loops

“…Limited‐sized defects are commonly repaired with local flaps; however, total gluteal defects pose a difficult and unique challenge. Regional tissue coverage for large gluteal defects have previously been described using multiple combination perforator‐pedicled propeller flaps (Scaglioni et al, 2020), proximally based anterolateral thigh flaps, tensor fascia lata flaps, or an extended IGA perforator V‐Y advancement flap for a unilateral defect (Vathulya et al, 2019). However, when the size of the defect becomes substantial, closure with regional options becomes difficult due to the limited volume of local soft tissue and lack of skin laxity.…”

“…In cases of total gluteal defects, reconstruction remains challenging due to limited locoregional flap options and the functional demands of the buttocks. Pedicled flaps (e.g., proximally based anterolateral thigh flaps or tensor fascia lata flaps) or pre‐expanded lumbosacral flaps are among a number of options to consider that have been reported in the literature, but often, free tissue transfer is necessary (Aggarwal & Pennington, 2013; Gaster et al, 2012; Park & Koh, 1998; Scaglioni et al, 2020; Tomita et al, 2015; Vathulya et al, 2019).…”