title: The inferior gluteal artery myocutaneous flap with vascularized fascia lata to reconstruct extended abdominoperineal defects.
abstract: Abdominoperineal resections have evolved to the point where increasing amounts of skin and pelvic floor are removed, resulting in extensive defects. Many patients receive neoadjuvant chemoradiotherapy and may require adjuvant treatment; thus, primary wound healing is essential. Existing reconstructive techniques may be inadequate and predispose to postoperative complications including wound breakdown and perineal herniation. The authors have developed a novel innervated gluteal flap reconstruction with significant advantages, including preservation of abdominal wall integrity, prone harvest, reliable vascularity, bulky volume, and tailored inset. This robust technique addresses all components required for successful perineal reconstruction comprising dead space obliteration, reconstruction and maintenance of perineal floor integrity, and importation of nonirradiated skin to facilitate primary wound healing. Indications can be extended to include reconstruction of the posterior vaginal wall and large sarcoma/sacrectomy defects.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Melbourne, Victoria, Australia From Western Health and St. Vincent's Hospitals.
authors.forename: Damien G
authors.initials: DG
authors.lastname: Grinsell
authors.forename: Edwin
authors.initials: E
authors.lastname: Morrison
authors.forename: Patrick D T
authors.initials: PDT
authors.lastname: Tansley
mesh_terms: D034861:Abdominal Wall / Q000473:pathology / Q000601:surgery*; D000368:Aged; D002081:Buttocks / Q000098:blood supply / Q000601:surgery*; D005206:Fascia Lata / Q000098:blood supply / Q000601:surgery*; D006801:Humans; D008297:Male; D010502:Perineum / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D012004:Rectal Neoplasms / Q000601:surgery; D013524:Surgical Flaps / Q000098:blood supply*; D014947:Wounds and Injuries / Q000209:etiology / Q000601:surgery*