The superior gluteal artery perforator flap to reconstruct lumbar soft tissue defects in the non-ambulatory patient

Abstract

The Superior Gluteal Artery Perforator (SGAP) flap has been described as both a free flap, in particular for breast reconstruction and as a pedicled flap for lumbar and sacral soft tissue reconstruction. Much of the evolution of the flap was through work on sacral pressure sores. Kroll and Rosenfield 1 Kroll S.S. Rosenfield L. Perforator-Based flaps for low posterior midline defects. Plast Reconstr Surg. 1988 Apr; 81: 561-566 Google Scholar described the use of perforator based flaps to reconstruct low posterior midline defects in the late 1980s. This work was further evolved by Koshima, 2 Koshima I. Moriguchi T. Soeda S. et al. The gluteal perforator based flap for repair of sacral pressure sores. Plast Reconstr Surg. 1993; 91: 678-683 Google Scholar whose work on pressure sores led him to explore the anatomy of the gluteal artery perforators. Verpaele 3 Verpaele A.M. Blondeel P.N. Van Landuyt K. et al. The superior gluteal artery perforator flap: an additional tool in the treatment of sacral pressure sores. Br J Plast Surg. 1999; 52: 385-391 Google Scholar modified this further by selecting the superior gluteal artery perforator as the flap of choice for reconstruction in the sacral area. Leow et al 4 Leow M. Lim J. Lim T.C. The superior gluteal artery perforator flap for the closure of sacral sores. Singapore Med J. 2004; Vol 45: 37-39 Google Scholar demonstrate the successful use of the flap in the management of sacral pressure sores in cases of acquired paralysis. The SGAP flap has not been described in the literature in patients who have been non-ambulatory since birth.