Guerra Aldo Benjamin, Metzinger Stephen Eric, Bidros Rafi Sirop, Gill Paul Singh, Dupin Charles Louis, Allen Robert Johnson
Department of Surgery, Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Ann Plast Surg. 2004 Feb;52(2):118-25. doi: 10.1097/01.sap.0000095437.43805.d1.
Fujino was the first to introduce gluteal tissue as a free flap for breast reconstruction. The use of the musculocutaneous flap from the buttock in breast reconstruction has been championed by Shaw. Despite the initial enthusiasm for this area as a donor site, few other large series exist on the subject. Two decades of experience with this region as a donor site led to recognition of advantages and drawbacks. Furthermore, use of both the superior and inferior gluteal musculocutaneous flap was associated with certain important donor site complications and the use of vein grafts to allow for microvascular anastomosis. The evolution of free tissue transfer has progressed to the level of the perforator flap. This reconstructive technique allows elevation of tissue from any region consisting only of fat and skin. This minimizes donor site morbidity by allowing preservation of the underlying muscle and coverage of important structures in the region such as nerves. The superior and inferior gluteal perforator flaps have been used at our institution for breast reconstruction since 1993. The superior gluteal artery perforator (S-GAP) flap is our preferred method of breast reconstruction when the abdomen is not available or preferable. We report the result of this flap over the past 9 years and point out important surgical refinements, advantages, disadvantages, and lessons learned during this time.
藤野是首个将臀组织作为游离皮瓣用于乳房重建的人。肖倡导在乳房重建中使用来自臀部的肌皮瓣。尽管最初人们对该区域作为供区充满热情，但关于这个主题的其他大型系列研究却很少。二十年来将该区域作为供区的经验让人们认识到了其优缺点。此外，使用臀上和臀下肌皮瓣会伴有某些重要的供区并发症，并且需要使用静脉移植来进行微血管吻合。游离组织移植的发展已进步到穿支皮瓣的水平。这种重建技术能够从仅由脂肪和皮肤构成的任何区域提起组织。通过保留深层肌肉以及覆盖该区域的重要结构（如神经），这将供区的发病率降至最低。自1993年以来，我们机构一直使用臀上和臀下穿支皮瓣进行乳房重建。当无法使用腹部或腹部并非首选时，臀上动脉穿支（S - GAP）皮瓣是我们进行乳房重建的首选方法。我们报告了过去9年中这种皮瓣的应用结果，并指出了在此期间重要的手术改进、优点、缺点以及所吸取的经验教训。
