A Comparison of Parasacral Perforator Flaps and Superior Gluteal Artery Perforator Flaps for Sacral Defects

Abstract

Background: Perforator-based flaps have become popular in modern reconstructive surgery because of low donor site morbidity and good preservation of muscle. Gluteal perforator flaps have been used widely for reconstructing sacral defects. We present our experience of using parasacral perforator flaps or superior gluteal artery perforator (SGAP) flaps in reconstructing sacral defects and compare the surgical outcomes. Methods: Between January 2003 and August 2009, 44 patients with sacral defects were included in this study. All the patients had undergone surgical reconstruction of sacral defects with a parasacral perforator flap or an SGAP flap. The patients’ gender, age, medical comorbidity, flap size, flap type, number of perforator used, rotation angle, postoperative drainage amount and postoperative complications were recorded, and a comparison was done between the two groups. Results: There were 27 SGAP flaps and 17 parasacral perforator flaps in this series. All survived uneventfully except for three SGAP flaps and one parasacral perforator flap. The flap survival rate was 91 percent (40/44). There were no significant differences between the two groups in flap size or survival (P=0.47). The mean operation time was significantly shorter in the parasacral flap group (P=0.01). Conclusion: Both parasacral perforator flaps and SGAP flaps are durable and reliable in reconstructing sacral defects. By saving operation time and offering a short learning curve for the surgeon, we recommend the parasacral perforator flap as a good choice for reconstructing sacral defects.