Abstract

BLANCO-ALVAREZ, Alberto; BENITO-DUQUE, Pablo  and  ALCAZAR-MONTERO, José-Antonio. Perineal reconstruction with gluteus maximus fasciocutaneus V-Y flap: 5 years experience. Cir. plást. iberolatinoam. [online]. 2016, vol.42, n.1, pp.29-34. ISSN 1989-2055.

Background and Objectives. Colorectal and gynecological surgery often demand the resection of large areas of tissue in the perineal region. Sometimes it is possible to perform direct closure of the zone but on other occasions reconstructive procedures are necessary. One of the techniques most widely accepted for perineal reconstruction is the use of V-Y fasciocutaneous flaps designed on the anatomical area of the gluteus maximus. Patients and Methods. We report 7 patients operated between 2005 and 2011, all of them undergoing reconstruction with V-Y fasciocutaneous flaps based on the perforating arteries of the gluteus maximus. The size of the lesions ranged between 50 to 400 cm². Results. The mean time spent in hospital was 36.8 days. Four patients developed complications on the operated zone (57%): 2 patients needed a second intervention owing to severe dehiscence; 1 patient developed an infection of the surgical wound; and in 1 patient the complication was an anal fistula. The oldest patient (80 years old) died during the post-operative period owing to cardiovascular problems. Conclusions. The fasciocutaneous V-Y advancement flap based on the gluteal region is a safe technique that is easy to perform and causes minimum morbidity in the reconstruction of small and large defects of the perineal region. However, in patients previously treated with radiotherapy, it is recommended that flaps be harvested from more distant areas.

Keywords : Perineal defect; Perineal reconstruction; Fasciocutaneous flap; V-Y flaps; Gluteus flaps.

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