Combined use of a petal flap and V–Y advancement flap for reconstruction of presacral defects following rectal resection

Background: The aim of this study was to evaluate the efficacy of a combination of flaps for the reconstruction of presacral defects following abdominoperineal resections: a paramedian vertically oriented caudally based lotus petal flap for presacral defects combined with a horizontal V–Y advancement flap for closure of the superficial donor site defect. Methods: A retrospective study was conducted on patients with a residual defect following an abdominoperineal resection between 2010 and 2017 in the Noordwest Ziekenhuisgroep. The primary endpoint was complications related to the reconstruction. Results: Twelve patients were included, all reconstructions healed well. Three patients had a grade I or II complication (Clavien Dindo classification). Conclusions: Use of a petal flap and V–Y advancement flap for reconstruction of presacral defects was found to be safe and simple, and should, therefore, be considered in the management of such problems.