Single-stage sacral coccygectomy and repair using human acellular dermal matrix (AlloDerm®) with bilateral gluteus maximus flaps for hernia prophylaxis

Sacrococcygectomy is often necessary for the ablation of malignancies involving the sacrum and coccyx, and can result in deep posterior peritoneal defects with disruption of the pelvic floor. Such a radical procedure is frequently associated with significant morbidity, including sacral herniation. Numerous techniques for the closure of the surgical defect have been described, with varying degrees of success in avoiding future herniation. We report the first single-stage coccygectomy and partial sacrectomy with closure utilizing human acellular dermal matrix (HADM) (AlloDerm®; LifeCell Corporation, Branchburg, NJ) and bilateral gluteus maximus transposition flaps.