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

## TL;DR

This paper reports three cases of postoperative buttock skin injuries that may be caused by ischemia-reperfusion rather than electrosurgical burns.

## Contribution

The study proposes a new hypothesis that some postoperative skin injuries result from ischemia-reperfusion rather than thermal injury.

## Key findings

- Three cases showed buttock skin lesions inconsistent with typical electrosurgical injury patterns.
- Clinical findings suggested underlying muscle involvement and ischemia-reperfusion-related injury.
- The report highlights the need for further studies on ischemic and mechanical factors in these lesions.

## 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.