To explore the therapeutic effect of the surgical approach combining staged debridement， vacuum sealing drainage and acellular dermal matrix and other appropriate techniques on gluteal muscle and skin necrosis after transcatheter arterial embolization （TAE）.

From August 2020 to September 2023， 6 patients with gluteal muscle and skin necrosis after TAE for massive hemorrhage caused by pelvic fracture who met the inclusion criteria were admitted to the Department of Plastic and Burn Surgery， Northern Jiangsu People's Hospital， including 4 males and 2 females， aged 42 to 65 years. All patients were treated with a surgical method combining staged debridement， vacuum sealing drainage and acellular dermal matrix and other appropriate techniques. The changes of creatine kinase levels after TAE and the CT or MRI imaging characteristics of gluteal muscle and skin necrosis were observed. The number of wound treatment operations， wound healing time and wound healing status were recorded.

The creatine kinase levels showed an overall upward trend from 1 to 3 days after TAE， peaked at 3 to 7 days after surgery， and maintained a high level （>10 000 U/L） for 2 to 7 days. CT or MRI showed edema of gluteal soft tissues and gluteal muscles （gluteus maximus， gluteus medius and gluteus minimus）， with uneven density of some muscles. The number of wound treatment operations was （4.7±0.8） times， and the wound healing time was （42.5±5.4） days. All 6 patients achieved good wound healing after surgery， and no wound rupture or exudation was found during the 2-month follow-up.

The combination of staged debridement， vacuum sealing drainage， acellular dermal matrix and other appropriate techniques can effectively treat gluteal muscle and skin necrosis after TAE.