Some gluteal skin defects are managed by wound bed preparation and negative pressure wound therapy（NPWT）for graft fixation. However, when a lesion is near the anus, film fixation becomes difficult due to the complex shape and maceration. Thus, there is a risk of leakage and contamination with stool. We report the use of gluteal fold flaps to treat a case of hidradenitis suppurativa of the buttocks, with good maintenance of negative pressure.
 A 60-year-old male with hidradenitis suppurativa of the buttocks underwent lesion resection and skin graft fixation using NPWT. However, the area of skin loss was near the anus, making it difficult to apply NPWT. We created a secure region near the anus using a gluteal fold flap, enabling film fixation. The site remained stable, and NPWT was uneventfully performed. The perianal area was reconstructed using a skin flap rather than skin grafting. Thus, anal function was preserved without contracture.
 This procedure is a useful option when performing NPWT for wounds near the anus.

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