Perfecting the design of the gluteus maximus perforator-based island flap for coverage of buttock defects.
BACKGROUND
The new design of the gluteus maximus perforator-based island flap for coverage of gluteal defects has the distinct advantage of being able to use customizable tissue components for coverage and at the same time sparing the source vessel. This adds a further option for use in reconstruction.


METHODS
After excisional débridement of the lesion, a perforator adjacent to the defect is selected. The tissue of the donor region is pinched to simulate closure. The change in shape of the recipient defect is noted and the dimensions of this new shape are measured. This will serve as the new dimensions of the donor tissue. The tissue components required to fill the defect are then analyzed and the flap is raised. It can be either muscle-sparing, muscle-splitting, or muscle-inclusive. A 1- to 2-cm diameter of soft tissue around the perforator is preserved. The flap is islanded and transposed, and the donor site is closed primarily, acting as a "locking barrier" to the flap. Tension-free closure of the recipient flap is then carried out. Seventy-five patients underwent closure of varying defects of the gluteal region using this technique.


RESULTS
The authors had a total of three minor complications. The rest of the patients healed well, with no recurrence at a mean follow-up of 15 months.


CONCLUSIONS
The flap design for coverage of gluteal defects has a great impact on recurrence and complications. This design is novel and the flap is simple to elevate. This is an ideal flap in any high-risk patient in whom the risk of recurrence is high.
Seoul, Korea; and Singapore From the Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, and the Division of Plastic, Reconstructive, and Aesthetic Surgery, Department of Surgery, National University Hospital.
Jeong Tae
JT
Kim
Youn Hwan
YH
Kim
Shenthilkumar
S
Naidu
D000328:Adult; D000368:Aged; D002056:Burns / Q000601:surgery; D002081:Buttocks / Q000601:surgery*; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D010019:Osteomyelitis / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*; D003668:Pressure Ulcer / Q000209:etiology / Q000601:surgery*; D016684:Prone Position; D011782:Quadriplegia / Q000150:complications; D018227:Sarcoma, Clear Cell / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000601:surgery; D013119:Spinal Cord Injuries / Q000150:complications; D013524:Surgical Flaps; D014945:Wound Healing; D014947:Wounds and Injuries / Q000601:surgery