Remove the skin and superficial fascia from the gluteal region, posterior thigh and upper leg along the following (approximate) lines.
- From the anterior superior iliac spine carry an incision along the iliac crest to the posterior superior iliac spine and then transversely to the midline (to meet the midline incision from the back dissection).
- Next make a midline incision over the sacrum and coccyx. Carry this incision in the anterior direction around the anus (stay approximately 5 cm from the anus) to a point approximately 5 cm lateral to the perineal body (to meet the incision made during the removal of the skin from the anterior and medial thigh).
- Return to the proximal leg. Make an incision around the posterior aspect of the leg (connecting the two earlier incisions that stopped approximately 10 cm inferior to the tibial condyles).
- Do not remove the deep fascia covering the posterior thigh. Do not remove the superficial fascia surrounding the anus (ishiorectal fossa).
- Attempt to identify the posterior femoral cutaneous nerve
