Gluteal Fasciocutaneous Flap Reconstruction after Salvage Surgery for Pelvic Sepsis

Saskia I. Kreisel, Sebastian Sparenberg, Sarah Sharabiany, Roel Hompes, Oren Lapid, Chantal M.A.M. Van Der Horst, Gijsbert D. Musters, Pieter J. Tanis

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

BACKGROUND: Chronic pelvic sepsis mostly originates from complicated pelvic surgery and failed interventions. This is a challenging condition that often requires extensive salvage surgery consisting of complete debridement with source control and filling of the dead space with well-vascularized tissue. OBJECTIVE: This study aimed to describe the outcomes of gluteal fasciocutaneous flaps for the treatment of secondary pelvic sepsis. DESIGN: Retrospective single-center cohort study. SETTINGS: Tertiary referral center. PATIENTS: Patients who underwent salvage surgery for secondary pelvic sepsis between 2012 and 2020 using a gluteal flap were included in this study. MAIN OUTCOME MEASURES: Percentage of complete wound healing. RESULTS: In total, 27 patients were included, of whom 22 underwent index rectal resection for cancer and 21 had undergone (chemo)radiotherapy. A median of 3 (interquartile range, 1-5) surgical and 1 (interquartile range, 1-4) radiological interventions preceded salvage surgery during a median period of 62 (interquartile range, 20-124) months. Salvage surgery included partial sacrectomy in 20 patients. The gluteal flap consisted of a V-Y flap in 16 patients, superior gluteal artery perforator flap in 8 patients, and a gluteal turnover flap in 3 patients. Median hospital stay was 9 (interquartile range, 6-18) days. During a median follow-up of 18 (interquartile range, 6-34) months, wound complications occurred in 41%, with a reintervention rate of 30%. The median time to wound healing was 69 (interquartile range, 33-154) days, with a complete healing rate of 89% at the end of follow-up. LIMITATIONS: Retrospective design and heterogeneous patient population. CONCLUSIONS: In patients undergoing major salvage surgery for chronic pelvic sepsis, the use of gluteal fasciocutaneous flaps is a promising solution because of the high success rate, limited risks, and relatively simple technique.

Original languageEnglish
Pages (from-to)1570-1577
Number of pages8
JournalDiseases of the Colon and Rectum
Volume66
Issue number12
DOIs
StatePublished - 1 Dec 2023
Externally publishedYes

Keywords

  • Fasciocutaneous flap
  • Gluteal flap
  • Pelvic sepsis
  • Pelvic surgery
  • Salvage surgery

ASJC Scopus subject areas

  • Gastroenterology

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