Wide posterior gluteal‐thigh propeller flap for reconstruction of perineal defects

With increasing popularity of minimally invasive approaches to abdominoperineal resection (APR), thigh‐based flaps are becoming the preferred option for reconstruction. The gluteal‐thigh flap provides sufficient bulk, albeit with a high complication rate. We reevaluated the vascularization and design of the gluteal‐thigh flap. The purpose of this study is to highlight the importance of the vascularization of the posterior thigh skin by the descending branch of the inferior gluteal artery (IGA) and the profunda femoris artery (PFA) perforators to design a more reliable and versatile gluteal thigh flap. This flap is indicated in selected cases in which use of vertical rectus abdominis musculocutaneous flap is not feasible.

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