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Gluteal Danger Zones
Carlos Ordenana MD, Edoardo Dalla Pozza MD, Sayf Said MD, Jennifer M. McBride PhD, Richard L. Drake PhD, Bassiri Bahar MD PhD, James Zins MD
Cleveland Clinic
2018-02-01
Presenter: Carlos Ordenana MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. Carlos Ordenana has made the majority of this work in conjunction with Edoardo Dalla Pozza.
Director Name: Bahar Bassiri
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: Aesthetics
Background:
Several authors have investigated operative features and patients' factors related to fat embolism following gluteal augmentation with fat grafting (GAFG). Inadvertent venous cannulation is likely to be the inciting factor. The aim of this study is to map the vascular danger zones of the gluteal area.
Methods: 20 dissections were performed in 10 fresh latex-injected cadavers. The dissection was performed layer by layer from skin to periostium evaluating the vascular density, size and vessel trajectory in the subcutaneous, intramuscular and submuscular planes. Each vessel and major nerve was tracked on a xyz axis. The diameter size of each vessel was measured with a digital caliper and recorded.
Results:
The gluteus maximus (GM) thickness was 25 ±4,08mm. The subcutaneous plane above the GM thickness measured 16,75 ±2.21mm, this plane contained the least number of vessels with the smallest average vein diameter (1,05 ±0,22mm). Intramuscular vein diameters increased to 1,3 ±0,3mm; and to 3,5 ±0,99mm in the submuscular plane. The superior and inferior gluteal vein diameter were 7,61±2,24mm and 13,65±6,55mm respectively. The profunda femoris vein was 3,09 ±0.44mm in diameter. Arteries were similarly measured and will be reported.
Conclusion:
The subcutaneous planes represent the least risk with regards to vascular complications. Intramuscular plane represent intermediate and the submuscular plane represents perhaps the greatest risk to vascular sequela.
