title: Use of gluteus maximus adipomuscular sliding flaps in the reconstruction of sacral defects after tumor resection.
abstract: BACKGROUND
  While performing sacrectomy from a posterior approach enables the en bloc resection of sacral tumors, it can result in deep posterior peritoneal defects and postoperative complications. We investigated whether defect reconstruction with gluteus maximus (GLM) adipomuscular sliding flaps would improve patient outcomes.
  
  
  METHODS
  Between February 2007 and February 2012, 48 sacrectomies were performed at He Nan Cancer Hospital, Zhengzhou City, China. We retrospectively examined the medical records of each patient to obtain the following information: demographic characteristics, tumor location and pathology, oncological resection, postoperative drainage and complications. Based on the date of the operation, patients were assigned to two groups on the basis of closure type: simple midline closure (group 1) or GLM adipomuscular sliding reconstruction (group 2).
  
  
  RESULTS
  We assessed 21 patients in group 1 and 27 in group 2. They did not differ with regards to gender, age, tumor location, pathology or size, or fixation methods. The mean time to last drainage was significantly longer in group 1 compared to group 2 (28.41 days (range 17-43 days) vs. 16.82 days (range 13-21 days, P < 0.05)) and the mean amount of fluid drained was higher (2,370 mL (range 2,000-4,000 mL) vs. 1,733 mL (range 1,500-2,800 mL)). The overall wound infection rate (eight (38.10%) vs. four (14.81%), P < 0.05) and dehiscence rate (four (19.05%)] vs. three (11.11%), P < 0.05) were significantly higher in group 1 than in group 2. The rate of wound margin necrosis was lower in group 1 than in group 2 (two (9.82%) vs. three (11.11%), P < 0.05).
  
  
  CONCLUSIONS
  The use of GLM adipomuscular sliding flaps for reconstruction after posterior sacrectomy can significantly reduce the risk of infection and improve outcomes.
authors.affiliation: Bone and soft tumor department, He Nan Cancer Hospital, The Affiliated Hospital of Zheng Zhou University, 127 Dong Ming Road, Zheng Zhou City 450000, China. ywtwhm@163.com
authors.forename: Yao
authors.initials: Y
authors.lastname: Weitao
authors.forename: Cai
authors.initials: C
authors.lastname: Qiqing
authors.forename: Gao
authors.initials: G
authors.lastname: Songtao
authors.forename: Wang
authors.initials: W
authors.lastname: Jiaqiang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002817:Chordoma / Q000150:complications / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005870:Giant Cell Tumors / Q000150:complications / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012447:Sacrum / Q000473:pathology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D013524:Surgical Flaps; D055815:Young Adult