Inferior Gluteal Artery Perforator Flap: Anatomic Study

Omari, Mounia El; Casoli, Vincent; Pinsolle, V.

doi:10.1007/978-3-319-18726-6_4

Cited by 1 publication

(1 citation statement)

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“…The large extent of the blood supply area of the flap permitted its use to reconstruct the superficial layer of pressure ulcers. An anatomical study showed that the mean area supplied by the IGAP is 22.1×10.2 cm, and the number of perforators is 7 to 14 17 . In our case series, we were able to save at least two perforators without intramuscular dissection, and the flap was elevated subfascially to as large as 10×20 cm.…”

Section: Discussionmentioning

confidence: 99%

A dual padding method for ischial pressure sore reconstruction with an inferior gluteal artery perforator fasciocutaneous flap and a split inferior gluteus maximus muscle flap

Lee

Yoon

et al. 2019

Arch Plast Surg

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BackgroundVarious surgical management methods have been proposed for ischial sore reconstruction, yet it has the highest recurrence rate of all pressure ulcer types. A novel approach combining the advantages of a perforator-based fasciocutaneous flap and a muscle flap is expected to resolve the disadvantages of previously introduced surgical methods.MethodsFifteen patients with ischial pressure ulcers with chronic osteomyelitis or bursitis, who underwent reconstructive procedures with an inferior gluteal artery perforator (IGAP) fasciocutaneous flap and a split inferior gluteus maximus muscle flap from January 2011 to June 2016, were analyzed retrospectively. The split muscle flap was rotated to obliterate the deep ischial defect, managing the osteomyelitis or bursitis, and the IGAP fasciocutaneous flap was rotated or advanced to cover the superficial layer. The patients’ age, sex, presence of bursitis or osteomyelitis, surgical details, complications, follow-up period, and ischial sore recurrence were reviewed.ResultsAll ischial pressure ulcers were successfully reconstructed without any flap loss. The mean duration of follow-up was 12.9 months (range, 3–35 months). Of 15 patients, one had a recurrent ulcer 10 months postoperatively, which was repaired by re-advancing the previously elevated fasciocutaneous flap.ConclusionsThe dual-flap procedure with an IGAP fasciocutaneous flap and split inferior gluteus maximus muscle flap for ischial pressure ulcer reconstruction is a useful method that combines the useful characteristics of perforator and muscle flaps, providing thick dual padding with sufficient vascularization while minimizing donor morbidity and vascular pedicle injury.

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Section: Discussionmentioning

confidence: 99%