Postoperative Buttock Skin Injuries Not Explained by Electrosurgical Burns: Three Cases Suggesting an Ischemia-Reperfusion Mechanism.

Abstract

Postoperative buttock skin lesions are uncommon complications that can cause severe pain and delayed healing. While often attributed to pressure, some clinical reports have classified them as electrosurgical burns. However, the electrophysical plausibility of this attribution under standard operating conditions is uncertain. We present three cases of buttock skin lesions appearing on the first postoperative day with severe pain and evidence of underlying muscle involvement. In each case, operative conditions, device usage, and clinical findings were inconsistent with typical electrosurgical injury patterns. These cases suggest that some postoperative buttock skin lesions may represent ischemia-reperfusion-related deep tissue injury rather than thermal injury. Given the limited sample size, this report is hypothesis-generating. Prospective studies are needed to clarify the roles of perioperative ischemic and mechanical factors in these lesions.