Reconstruction of an extensive perineal defect using two modified V-Y flaps based on perforators from the gluteus maximus muscle.

SUMMARY: We report the case of a women with severe perineal defect secondary to a perianal cancer that required reconstruction from the posterior wall of the urinary bladder to the coccyx, and which laterally surpassed both ischial tuberosities. For this reconstructive work, we used two V-Y advanced flaps taken from the gluteal region. On the basis of these flaps, we modified the final position in the advance of the lateral ends, crossing the tips of each flap over each other to provide a greater volume of tissue in the central area, with no signs of vascular injury. We believe that the use of V-Y flaps, based on the perforating arteries of the gluteus maximus, allows the reconstruction of especially extensive defects in the perineal region. The technique is rapid and easy perform, and produces acceptable clinical outcome and minimum morbidity.