Effects of free perforator propeller flap from buttock in repairing deep wound of buttock

Objective To explore the effects of free perforator propeller flap from buttock in repairing deep wound of buttock. Methods From February 2016 to May 2018, 27 patients with buttock skin and soft tissue defects caused by various reasons were admitted to the Burn and Plastic Surgery Center of the 940th Hospital of the Joint Logistic Support Force of People′s Liberation Army, including 19 males and 8 females, aged from 28 to 70 years. Among the protopathy, there were 14 cases of pressure sores, 7 cases of scar carcinoma, 2 cases of low-temperature scald, 2 cases of abscess, and 2 cases of pilonidal sinus. The wounds were located in the sacrococcygeal region in 15 cases, the ischial tuberosity in 8 cases, and the rest area of buttock in 4 cases after injury or lesion resection. The size of wounds ranged from 4.0 cm×4.0 cm to 12.0 cm×6.0 cm after debridement or extended resection. The free perforator propeller flaps from buttock with areas of 8.0 cm×4.0 cm-16.0 cm×6.0 cm were used to repair the wounds, and the donor sites were selected adjacent to the wounds where the skins were relatively loose. All flaps took buttock free perforator vessels as the axis and were transferred in propeller-type to repair the wounds. The donor sites were directly closed and sutured. The survival, complications, and follow-up of flaps were recorded. Results All the flaps survived 100% in 27 patients. Congestion formed under flaps 2-6 days post operation in 2 patients due to inadequate drainage, which were healed after dressing change and drainage for 14-18 days. The sutures of flaps in the other cases were removed in 10-14 days post operation, and the wounds were healed. Follow-up for 2-12 months showed that the shapes of flaps and the donor sites were plump, which were not much different from the healthy sides, and the flaps could bear weight. Conclusions Repairing buttock deep wound with buttock free perforator propeller flap has good effects. The donor site can be designed in the area adjacent to the wound where the skin is relatively loose and can be directly closed and sutured while repairing the wound, which can ensure plump buttock appearance.