Arch Plast Surg.  2014 Mar;41(2):140-147. 10.5999/aps.2014.41.2.140.

Perforator Flaps after Excision of Large Epidermal Cysts in the Buttocks

• Kim SW
• Yang SH
• Kim JT
• Kim YH

• KMID: 1972037
• DOI: http://doi.org/10.5999/aps.2014.41.2.140

Abstract

BACKGROUND
Epidermal cysts are commonly occurring masses usually less than 5 cm in diameter, but in predisposed patients, epidermal cysts can grow relatively large due to chronic infection.
METHODS
From June 2002 to July 2010, 17 patients received 19 regional perforator-based island flaps to cover defects due to the excision of large epidermal cysts (diameter >5 cm) in the buttocks. Eight patients had diabetes, and seven had rheumatoid arthritis. The pedicles were not fully isolated to prevent spasms or twisting.
RESULTS
All the flaps survived completely, except for one case with partial necrosis of the flap, which necessitated another perforator-based island flap for coverage. There were two cases of wound dehiscence, which were re-closed after meticulous debridement. There were no recurrences of the masses during follow-up periods of 8.1 months (range, 6-12 months).
CONCLUSIONS
In patients with large epidermal cysts and underlying medical disorders, regional perforator-based island flaps can be the solution to coverage of the defects after excision.

Keyword

Epidermal cyst; Perforator flap; Surgical flaps

MeSH Terms

Arthritis, Rheumatoid
Buttocks*
Debridement
Epidermal Cyst*
Follow-Up Studies
Humans
Necrosis
Perforator Flap*
Recurrence
Spasm
Surgical Flaps
Wounds and Injuries