Gluteal Perforator Flaps for Coverage of Sacral Pressure Sores

Heo, Chan Yeong; Jung, Jae Hoon; Lee, Sang Woo; Kim, Jung Yoon; Kwon, Soon Sung; Baek, Rong Min; Minn, Kyeong Won; Kim, Yong Kyu

Abstract

PURPOSE: Gluteal perforator is easily identified in the gluteal region and gluteal perforator flap is a very versatile flap in sacral sore reconstruction. We obtained satisfying results using the gluteal perforator flap, so we report this clinical experiences with a review of the literature.
METHODS
Between November of 2003 and April 2006, the authors used 16 gluteal perforator flaps in 16 consecutive patients for coverage of sacral pressure sores. The mean age of the patients was 47.4 years (range, 14 to 78 years), and there were 9 male and 7 female patients. All flaps in the series were supplied by musculocutaneous arteries and its venae comitantes penetrating the gluteus maximus muscle and reaching the intrafascial and suprafascial planes, and the overlying skin forming a rich vascular plexus arising from gluteal muscles. Patients were followed up for a mean period of 11.5 months.
RESULTS
All flaps survived except one that had undergone total necrosis by patient's negligence. Wound dehiscence was observed in three patients and treated by secondary closure. There was no recurrence during the follow-up period.
CONCLUSION
Gluteal perforator flaps allow safe and reliable options for coverage of sacral pressure sores with minimal donor site morbidity, and do not sacrifice the gluteus maximus muscle and rarely lead to post- operative complications. Freedom in flap design and easy-to perform make gluteal perforator flap an excellent choice for selected patients.