Case 22 2026: Superior Gluteal vessel: A rarely used recipient for free flap reconstruction of lumbosacral defects: a case report.

Keywords: Superior gluteal vessel, free flap reconstruction, lumbosacral defects Authors: 1. Tushar Dutta, Consultant Plastic Surgeon; 2. Arun PS, Consultant Surgical Oncologist; 3. Swati Sattavan, Consultant Surgical Oncologist; Institute: State Cancer Institute, Guwahati, Assam, India Abstract Lumbosacral defects that are too large for local flap reconstruction should be considered for microvascular free tissue transfer. However, lack of suitable recipient vessels in the area makes the task technically difficult. Options such as thoracodorsal and inferior gluteal vessels extended with vein grafts and AV loops have been described. Each option has its own drawbacks. Despite having a short course at its origin, the superior gluteal vessel is a viable alternative. We describe here a case where the vessel was dissected out with adequate length and used as a recipient for free flap reconstruction. Patient medical history The patient was a 41-year-old lady with no known comorbidities. She presented to us with a large lumbosacral mass that had been growing for one year. Before visiting our center, she had been operated twice at other institutions and had recurrences after each occasion. During the last three months the mass had started to grow rapidly and caused ulceration. There was no pain or fever. There was no neurological involvement of lower limbs. Patient had an ECOG status 1. Before and After Patient examination A 17x 22 cm mass was noted encompassing the left part of lumbosacral region and crossing the midline to the opposite side. The superior limit of the lesion was at the L3 vertebra and inferior extent was near the coccyx. Skin ulceration was noted at the center of the mass. On palpation, the mass was warm to touch, hard in consistency and immobile. Skin was fixed and fixity was also noted to the underlying muscle. No tenderness was elicited. Surrounding possible donor sites for flap harvest showed no scars. Pre-operative considerations Preoperative biopsy co