{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T17:29:06Z","timestamp":1750181346683,"version":"3.40.5"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T00:00:00Z","timestamp":1589500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Soft tissue defects in the buttock area are often related to decubitus ulcers, which are usually small to medium\u2010large size and can be regularly treated with local flaps. However, when the defects have bigger size, such as those involving the whole gluteal region, the coverage can become more challenging, since this specific area needs both a good resistance to pressure and an acceptable functional result. The most common solution for similar cases is the use of multiple local flaps, or, in extreme situations, a free flap. In particular, local flaps based on perforator vessels are, in selected cases, a consolidated alternative to free flap allowing an efficient reconstruction of soft tissue defects using adjacent similar tissues, providing the benefit of \u201clike with like\u201d coverage. Here we present a case of a large mycosis fungoides nidus of the gluteal region measuring 25\u2009cm \u00d7\u200918\u2009cm reconstructed using two large perforator flaps adjacent to the defect combined with a remote one for coverage of the donor site. The cranial flap was designed based on a perforator arising from the superior gluteal artery and transferred into the defect by means of a V\u2013Y advancement, while the two caudal propeller flaps in the posterior thigh were both based on perforators of the profunda femoris artery and rotated 180\u00b0, respectively. To obtain a tension\u2010free cover of the donor site defect we applied the concept of \u201csequential\u201d propeller flaps. Post\u2010operative course was uneventful and the patient was ambulatory with assistive devices after 1 week. At 6 months follow\u2010up, wounds were completely healed without complications and a good functional result was obtained. This report showed the great coverage potential of multiple perforator\u2010based local flaps when properly combined allowing primary closure of the donor site. In particular, we managed to reconstruct a total gluteal defect using just ipsilateral side tissue, reducing morbidity, and obtaining a stable result.<\/jats:p>","DOI":"10.1002\/micr.30605","type":"journal-article","created":{"date-parts":[[2020,5,16]],"date-time":"2020-05-16T05:13:43Z","timestamp":1589606023000},"page":"797-801","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Soft tissue coverage of a total gluteal defect with a combination of perforator\u2010based flaps: A case report"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5289-9140","authenticated-orcid":false,"given":"Mario F.","family":"Scaglioni","sequence":"first","affiliation":[{"name":"Depatment of Hand and Plastic Surgery Cantonal Hospital of Lucerne  Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vendela","family":"Grufman","sequence":"additional","affiliation":[{"name":"Depatment of Hand and Plastic Surgery Cantonal Hospital of Lucerne  Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Meroni","sequence":"additional","affiliation":[{"name":"Depatment of Hand and Plastic Surgery Cantonal Hospital of Lucerne  Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elmar","family":"Fritsche","sequence":"additional","affiliation":[{"name":"Depatment of Hand and Plastic Surgery Cantonal Hospital of Lucerne  Lucerne Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,5,15]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22279"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-200206000-00025"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000002089"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000723"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001175"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000007455"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30172"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22427"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181f02ee3"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2011.05.019"},{"issue":"3","key":"e_1_2_5_12_1","first-page":"112","article-title":"Surgical 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