Reconstruction of extensive pilonidal sinus defects with the use of S-GAP flaps.

Pilonidal sinus is a chronic intermittent inflammatory condition that is predominantly located in the sacrococcygeal region. For the closure of uncomplicated small pilonidal sinuses, conventional therapeutic techniques including total excision of the sinus and leaving the defect open for secondary healing have been reported with varying success rates. However, the treatment of recurrent and extensive disease remains as a difficult condition. The ideal treatment should be associated with short hospital stay, minimal complication rates, and no disease recurrence. Secondary wound healing after large excision results in a chronic wound that requires cleansing and dressing changes for a long time. The condition also negatively affects the patient's social life. With the progression of reconstructive techniques, the lowest recurrence rates for the treatment of extensive disease have been reported after local flap usage. The purpose of the current article is to report the efficacy of superior gluteal artery perforator flap in the reconstruction of extensive sacrococcygeal pilonidal sinus defects. This perforator flap is a refinement of the classic gluteal musculocutaneous flaps, which have been popularly used for the closure of sacral pressure sores over many years.

Versatility of frontal island flaps in the reconstruction of periorbital soft tissue defects.

The reconstruction of large soft tissue defects in the orbital and maxillomalar region is a challenging task that necessitates the consideration of both functional and aesthetic outcomes. We used the frontal island skin flap in patients with full-thickness soft tissue defects of the periorbital and malar region. In the reconstruction of full-thickness defects of this particular region, the alternatives to this flap are other regional flaps or distant free flaps. Not every pedicled regional flap can be transferred to every defect and most of the time the application of distant free flaps increases the morbidity of the procedure. The surgeon must be capable of being able to select the most useful and comprehensive flap within a range of many alternatives. We present our experience in 10 patients with complex soft tissue defects in the maxillomalar and periorbital regions whose defects were reconstructed with frontal artery island skin flaps.