Pedicled Fasciocutaneous Flap of Multi-island Design for Large Sacral Defects

Abstract

We designed a new pedicled fasciocutaneous flap for large sacral defects that combined a classic superior gluteal artery perforator flap and an acentric axis perforator pedicled propeller flap. We asked whether this technique would be simple and result in few complications. Six patients with large sacral defects had reconstruction using this technique in one stage. The size of the defect and postoperative complications in each patient were assessed. The minimum followup was 6 months (mean, 20.1 months; range, 6-38 months). All wounds healed with no recurrence during followup. Five patients achieved healing primarily, and another with minimal drainage achieved healing by secondary intention after a dressing change. No patients had deep infection, wound dehiscence, necrosis, or partial loss or shrinkage of the flap at final followup. The buttocks were symmetric. We consider this a good alternative for reconstructing large sacral defects because it is a relatively simple procedure and results in few complications.

Surgical Outcomes after Abdominoperineal Resection with Sacrectomy and Soft Tissue Reconstruction: Lessons Learned

“…30,31 While they continue to be a preferable option for decubitus ulcers, breast reconstruction, and pilonidal sinus disease, modifications of the GAP flaps have recently been adopted for reconstructing more extensive sacral defects created by oncologic resection. [32][33][34][35] Additional flaps are sometimes required for more extensive defects which may not be amenable with a single flap. In our cohort, two patients had an omental flap and one had a gluteal flap in addition to their VRAM flaps.…”

Surgical Treatment of 55 Patients with Pressure Ulcers at the Department of Plastic and Reconstructive Surgery Kosovo during the Period 2000–2010: A Retrospective Study

“…Debridement of pressure sores often results in extensive soft tissue defects that cannot be closed primarily and are further associated with increased risk of flap ischemia, wound dehiscence, and deep infection [12]. Numeral surgical methods have been used to correct these defects, including skin grafting [12, 13], local flaps [12, 14], muscle flaps [12, 15], and free flaps [12, 16].…”

“…Numeral surgical methods have been used to correct these defects, including skin grafting [12, 13], local flaps [12, 14], muscle flaps [12, 15], and free flaps [12, 16]. …”

Perforator Flap is Better Option for Sacral Pressure Ulcer Repair because of Fewer Complications: Comparative Study of 20 Perforator and 11 Rotation Flap Surgeries

“…Koshima I, et al, [20] reported that in eight pressure ulcers treated with gluteal perforator flaps, one fistula occurred. Lin PY, et al, [21] identified one seroma in 46 gluteal perforator flaps; Xu Y, et al, [22] also noted one seroma among six flaps. Leow M, et al, [23] reported four successful gluteal perforator flap surgeries without seroma formation.…”