The following is a summary of “Gluteal Fasciocutaneous Flap Reconstruction After Salvage Surgery for Pelvic Sepsis,” published in the December 2023 issue of Gastroenterology by Kreisel, et al.
Most cases of chronic pelvic sepsis are caused by difficult pelvic surgery or treatments that didn’t work. This is a tough disease that usually needs a lot of surgery to fix it. The surgery included cleaning out the whole area, stopping the source of the infection, and filling the empty space with healthy tissue with blood vessels. For a study, researchers sought to look at how well gluteal fasciocutaneous patches worked for treating secondary pelvic sepsis. They looked at people who had salvage surgery for secondary pelvic sepsis between 2012 and 2020.
The operation used a gluteal flap. Twenty-two of the patients had index rectal removal for cancer, and the other twenty-one had (chemo)radiotherapy. Throughout 62 (interquartile range, 20–124) months, rescue surgery came after an average of 3 (interquartile range, 1–5) surgical and 1 (interquartile range, 1–4) imaging interventions. Twenty of the patients who had salvage surgery had a partial sacrectomy. The gluteal flap was made up of a V-Y flap for 16 patients, an SGA perforator flap for 8 patients, and a gluteal turnover flap for 3 patients.
A median hospital stay of 9 days (interquartile range, 6–18 days) was found. The average follow-up time was 18 months, but the range was between 6 and 34 months. Wound problems happened in 41% of patients, and 30% needed more surgery. The average time for a cut to heal was 69 days, ranging from 33 to 154 days. 89% of wounds were fully healed at the end of the follow-up period. The use of gluteal fasciocutaneous flaps is a hopeful option for people who are going to have major rescue surgery for chronic pelvic sepsis because they have a high success rate, few risks, and are easy to do.
