Partially De-epithelised Gluteus Maximus Myo-facio-cutaneous Advancement Flap Cover: A Newer Reconstructive Option for Sacral Defects

Abstract

Pressure sores or infected pilonidal sinus resulting into sacral defect is a challenge in view of reconstruction frequently faced by a plastic surgeon. Many flaps have been proposed for the same out of which muscle and myocutaneous flaps are associated with better surgical outcome due to its durable coverage and superior blood supply. In this current study, we introduce a novel technique of partially de-epithelised Gluteus maximus myo-facio-cutaneous advancement flap cover for sacral defects resulting due to bedsores as well as pilonidal sinus. This study was conducted from April 2016 - April 2017, a total of 30 patients underwent reconstruction of sacral defects post pilonidal sinus excision as well as grade 3-4 bed sores. Post-operatively the flaps were evaluated in terms of incidence of flap necrosis, infection, rate of healing, aesthetic outcome and rate of recurrence. All 25 flaps healed with fair post-operative outcome with no significant complications. Thus, partially de-epithelised Gluteus maximus myo-facio-cutaneous advancement flap cover efficiently reconstructs sacral defects and proves to be a safe, durable option with excellent aesthetic outcome.