The Sliding Plication Gluteus Maximus Musculocutaneous Flap for Reconstruction of Sacrococcygeal Wounds

Abstract

The technique of the sliding gluteus maximus muscle flap as originally described has allowed closure of defects up to 20 cm in transverse diameter. However, this requires extensive dissection and mobilization of the musculocutaneous units. A modification of the original flap is described. In this technique, there is no subcutaneous dissection. The dissection is limited to the submuscular plane of the lower portions of the muscle origin. These modifications lessen the amount of dissection and blood loss and shorten the operative time. This had permitted closure of sacrococcygeal defects up to 12 cm in transverse diameter. Twenty-two patients with a variety of sacrococcygeal defects were successfully reconstructed with this technique.