Contouring buttock reconstruction after sacrococcygeal teratoma resection

• Published in: Journal of pediatric surgery 2004-03, Vol.39 (3), p.439-441
• Main Authors: Fishman, Steven J, Jennings, Russell W, Johnson, Sidney M, Kim, Heung B
• Format: Article
• Language: English
• Subjects: buttock; Buttocks - surgery; Cicatrix - prevention & control; Humans; Infant; reconstruction; Reconstructive Surgical Procedures - methods; Sacrococcygeal Region - surgery; Sacrococcygeal teratoma; Spinal Neoplasms - surgery; Teratoma - surgery
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2003.11.036

Massive sacrococcygeal teratomas are typically resected and closed in a “chevron” fashion. The resultant scar may leave protuberant “dog ears” and extend across and below the infragluteal creases down onto the posterior thighs, causing undesirable buttock deformity. Given the redundant skin often available, the authors sought to develop a closure technique to minimize deformity and unpleasant scars. At the time of resection of 2 sacrococcygeal teratomas, attention was directed to minimizing redundant skin, restoring normal buttock contour, and avoiding scars crossing the infragluteal crease. After properly securing the anal location, serial polygonal skin excisions were performed, working the excess tissue centrally rather than peripherally, leaving 2 right-angled scars on each buttock. Each infant underwent successful reconstruction with a normal buttock contour without redundancy. All scars on the buttocks can be easily covered by bathing attire. The excess skin expanded by large sacrococcygeal teratomas affords an opportunity to apply straightforward tissue rearrangement principles to reconstruct the buttocks with a normal contour and hidden scars.