Shallow perineal defects may be closed utilising single or bilateral gluteus maximus V-Y flaps. The origins of the gluteal muscles are detached from their attachment to the sacrum, advanced medially and secured to each other in the midline. A V-shaped incision is made in the posterior/lateral buttock skin down to the gluteal muscle. The musculocutaneous unit is advanced medially and a midline closure is performed without tension. The donor site is closed as a V-Y plasty . Hurst et al.  utilised this flap in 4 of 12 patients (12.4% of 97 patients submitted to proctectomy for Crohn's disease) achieving primary closure.
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