Editor Choice: Reconstruction of Extensive Defects From Posterior En Bloc Resection of Sacral Tumors With Human Acellular Dermal Matrix and Gluteus Maximus Myocutaneous Flaps

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BACKGROUND: Performing a sacrectomy from an exclusively posterior approach allows the en bloc resection of tumors without the morbidity of a laparotomy. However, reconstruction of the resultant extensive soft-tissue defects is challenging because a vertical rectus abdominis myocutaneous flap is not harvested.

OBJECTIVE: To report the largest series (with the longest follow-up) of sacral reconstructions using a combination of human acellular dermal matrix (HADM) and gluteus maximus myocutaneous flaps.

METHODS: Thirty-four patients with sacral tumors with a follow-up of at least 1 year were reviewed retrospectively. After the tumor was excised, HADM (AlloDerm, LifeCell Corp, Branchburg, New Jersey) was secured to create a pelvic diaphragm. Subsequently, the gluteus maximus muscles were freed from their origins and advanced to cover the HADM.