title: [Aesthetic gluteal region reconstruction with a perforator artery flap].
abstract: The gluteal region is an important pressure zone in every day life. Defects associated with bone exposure in the sacral region are more frequent among pressure sores. The gold standard treatment consists in a musculocutaneous gluteal flap; it can have as side effects functional deficits for walking and an important scar. In order to diminish the donor site morbidity muscle sparing flaps, as perforator flaps, have been described. The purpose of this article is to report the case of a 29-year-old patient with a median sacral defect with bone exposure after oncological resection, covered by a perforator gluteal flap. A superior gluteal artery perforator was researched using a Doppler flowmetry. The role of the perforator was to make the flap more reliable and to obtain a higher degree of mobilization of the flap devoid of tension or flap morbidity, without interfering with the gluteus maximus muscle integrity. Also, the aesthetic units of the gluteal region have been considered in order to obtain a better scar quality. At the 4 months follow-up, the result was stable with a discrete scar and no walking difficulties. In conclusion, the median defects associating bone exposure in the sacral region are difficult to treat, especially in young patients. The treatment should consist in a stable soft tissue coverage with minimal functional and aesthetic sequela. The perforator gluteal flap respects the aesthetic units and can be considered as an elegant and efficient solution to treat this type of defects.
authors.affiliation: Département de chirurgie plastique et reconstructrice, centre régional Léon-Bérard, 28 rue Laennec, Lyon, France. choquoc69@gmail.com
authors.forename: C
authors.initials: C
authors.lastname: Ho Quoc
authors.forename: F
authors.initials: F
authors.lastname: Boucher
authors.forename: P
authors.initials: P
authors.lastname: Meeus
authors.forename: A
authors.initials: A
authors.lastname: Boespflug
authors.forename: E M
authors.initials: EM
authors.lastname: Neidhart
authors.forename: E
authors.initials: E
authors.lastname: Delay
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D001158:Arteries / Q000601:surgery; D002081:Buttocks / Q000098:blood supply* / Q000601:surgery*; D002921:Cicatrix / Q000517:prevention & control; D004954:Esthetics; D005500:Follow-Up Studies; D006801:Humans; D017078:Laser-Doppler Flowmetry; D061525:Perforator Flap; D010864:Pilonidal Sinus / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012445:Sacrococcygeal Region / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D020858:Tissue and Organ Harvesting / Q000379:methods