SGAP Flap for Reconstruction of Sacral Pressure Sores

Abstract

From August 2004 to October 2005 we underwent 13 procedures using SGAP(superior gluteal artery perforator)as pedicles by either advancement(8/13)or interpolated(5/13)flaps in reconstruction of twelve sacral ulcers in twelve patients. Three(two interpolated and one advanced flaps)of the thirteen procedures were complicated with venous congestion and hematoma, two were saved by decompression with tunnel widening and flap debulking, however the other one interpolated flap was lost post salvage and the defect needed resurfacing by a V-Y advancement SGAP flap from the opposite side. Ten of the thirteen flaps survived completely without morbidity and only one recurrence noted after an average 10 months follow-up. We found the interpolative moving of flaps and the thickness discrepancy between defects and flaps (the SGAP flaps were usually too bulky for shallow sacral ulcers)may increase the risk for torsion of pedicle and venous congestion that resulted in serious complication even flap loss.