Plastisch-chirurgische Rekonstruktion gluteal mit freien Lappenplastiken

Purpose Large and bulky soft tissue defects in the gluteal, perineal and sacral regions are a reconstructive challenge, especially if suitable local flaps are not available. In such cases, a free flap may be necessary, the choice of which depends on the size and depth of the defect and the available recipient vessels. Patients/Materials and Methods In this study, different options for defect coverage in this area are analysed and evaluated. Particular attention is paid to the choice of recipient vessel, flap and surgical planning. Results Free flap is an effective and safe method for the reconstruction of large soft tissue defects in the gluteal, perineal and sacral regions. The superior and inferior gluteal arteries are the preferred recipient vessels, but arteriovenous (AV) loops can serve as alternatives when primary vessels are not available. While the latissimus dorsi flap is particularly suitable for flat defects, the vastus lateralis flap offers advantages for deep or voluminous defects, due to its volume. Conclusion Microsurgical reconstruction of these defects requires individual planning, depending on patient factors, defect morphology and vascular conditions. The choice of the appropriate flap and careful selection of the recipient vessel are decisive for the reconstructive success of this complex procedure.