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Modification of Superior Gluteal Artery Perforator Flap for Reconstruction of Sacral Sores

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Background: Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The superior gluteal artery perforator (SGAP) flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. However, the dissection of the perforator is tedious and carries a risk of compromising the perforator vessels. Methods: We modified the harvesting technique into two flap designs: a rotational and a tunnel method with only a short pedicle dissection to cover 12 sacral sores. Results: All flaps survived except one, which had flap tip necrosis and was treated by secondary closure. Conclusion: The advantages of this modification include a faster operation, less bleeding, and less trauma of the pedicle, which make the SGAP flaps an excellent choice for sacral pressure sore coverage.

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