Management of a complicated colonexposed sacrococcygeal wound after pelvic exenteration: a case report

Abstract

Sacrococcygeal wound management can be challenging, especially when complicated by chronic infection, radiation and exposure of the underlying structures. Vascularised soft-tissue reconstruction is the only option when conservative wound care fails. Previous reports have mainly focused on the treatment of pressure ulcers. This report describes the case of a 54-year-old female patient with a colon-exposed, large sacrococcygeal wound after pelvic exenteration for recurrent rectal cancer. The wound was closed without dead space using two approaches: innovative vacuum sealing drainage (VSD); and gluteus maximus myocutaneous flap repair. Timely debridement, accurate assessment of intervention, appropriate design of composite tissue flap, and conscientious wound care contributed to complete wound healing within two months. Declaration of interest: This work was supported by the Naval Medical University and the University of Shanghai for Science and Technology Joint Projects (2020-RZ04), the Innovative Clinical Research Program of Shanghai Changzheng Hospital (2020YLCYJ-Y16), and the academic project of Naval Medical University (2022QN073). The authors have no conflicts of interest to declare.