title: Perforator flaps after excision of large epidermal cysts in the buttocks.
abstract: BACKGROUND
  Epidermal cysts are commonly occurring masses usually less than 5 cm in diameter, but in predisposed patients, epidermal cysts can grow relatively large due to chronic infection.
  
  
  METHODS
  From June 2002 to July 2010, 17 patients received 19 regional perforator-based island flaps to cover defects due to the excision of large epidermal cysts (diameter >5 cm) in the buttocks. Eight patients had diabetes, and seven had rheumatoid arthritis. The pedicles were not fully isolated to prevent spasms or twisting.
  
  
  RESULTS
  All the flaps survived completely, except for one case with partial necrosis of the flap, which necessitated another perforator-based island flap for coverage. There were two cases of wound dehiscence, which were re-closed after meticulous debridement. There were no recurrences of the masses during follow-up periods of 8.1 months (range, 6-12 months).
  
  
  CONCLUSIONS
  In patients with large epidermal cysts and underlying medical disorders, regional perforator-based island flaps can be the solution to coverage of the defects after excision.
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Sang Wha
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Seong Hyeok
authors.initials: SH
authors.lastname: Yang
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Jeong Tae
authors.initials: JT
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Youn Hwan
authors.initials: YH
authors.lastname: Kim
keywords: Epidermal cyst; Perforator flap; Surgical flaps