Superior Gluteal Artery Research Articles

Intratissue lymphovenous communications in the mechanism of action of vascularized lymph node transfer.

Vascularized lymph node transfer (VLNT) as a surgical treatment for cancer-related lymphedema has shown beneficial effects. The mechanism of action of this procedure involves lymphangiogenesis and lymphovenous communications (LVC) within the lymph nodes. We propose intratissue LVC as an additional element responsible for drainage of lymph to blood in the flap and examine this hypothesis in the current study. This prospective study determined the passage of lymph to the venous system via intratissue LVC in 26 free flaps used for breast reconstruction. We evaluated whether fluorescence was positive in the pedicle vein after increasing time intervals following intradermal injection of indocyanine green (ICG) dye into the flaps using near infra-red fluorescence lymphography. We studied 26 free flaps, 22 deep inferior epigastric perforator (DIEP) flaps (84.6%), and 4 superior gluteal artery perforator (SGAP) flaps (15.4%). Fluorescence in the pedicle vein was positive in 22 of the 26 flaps (P = 0.000). The median time for fluorescence evaluation in the pedicle vein was 120 min. Fluorescence in the pedicle vein after ICG intradermal injection indicates functional intratissue LVC in free flaps. J. Surg. Oncol. 2017;115:27-31. © 2016 Wiley Periodicals, Inc.

The Response of Pelvic Complex under Lateral Impacting

The pelvic complex FE model consists of hard tissue, ligaments, artery and soft tissue was developed. The lateral impact loading in right trochanter with 3m/s initial velocity was applied on the model, and the response of different anatomies was analyzed. The results showed that the external iliac artery and superior gluteal artery of the impacting side prone to be injured during the lateral impacting for the latter artery pressure was -17.2KPa and the former pressure was -33.2KPa. The contact force was 3230N at 14.5ms.

Gluteal compartment syndrome and delayed hemorrhage of superior gluteal artery following an old pelvic fracture: a case report

Gluteal compartment syndrome and delayed hemorrhage of superior gluteal artery following an old pelvic fracture: a case report

Profound Hypotension in L2 Burst Fracture Patient Associated with Superior Gluteal Artery Rupture

Profound Hypotension in L2 Burst Fracture Patient Associated with Superior Gluteal Artery Rupture

An Application of Keystone Perforator Island Flap for Closure of Lumbosacral Myelomeningocele Defects.

Myelomeningocele, also known as spina bifida, is the commonest form of neural tube defect in which both meninges and spinal cord herniate through a large vertebral defect. It may be located at any spinal level; however; lumbosacral involvement is most common. After birth, the closure of spinal lesion is preferably undertaken in the first 48 hours to minimize the risk of injury and central nervous system infection. Relatively small skin defects overlying the dural repair may be directly closed. However, larger defects require reconstructive closure. Numerous methods of reconstruction have been described, such as split skin graft, local flaps or lumbosacral fasciocutaneous flaps, muscle flaps using latissimus dorsi, gluteal or paraspinous muscles, and perforator flaps namely superior gluteal artery perforators, and dorsal intercostal artery perforator flaps. At Monash Health, Victoria, we have used the keystone perforator island flaps to reconstruct lumbosacral myelomeningocele defects on 5 newborns between January 2008 and January 2014. This article evaluates the short-term and long-term outcomes of these patients who were followed up for 10 to 66 months.

Variation in the Obturator Vasculature During Routine Anatomy Dissection of a Cadaver.

The obturator artery normally originates from the internal iliac artery while the obturator vein drains into the internal iliac vein. During a routine gross anatomy dissection class for undergraduate students at the All India Institute of Medical Sciences, New Delhi, India, in 2016, a rare unilateral variation in the obturator vasculature was found in a female cadaver of approximately 55 years of age. In this case, the left obturator artery originated from the superior gluteal artery and the left obturator vein drained into the external iliac vein. Knowledge of such variations is necessary during hernia procedures, ligation of the internal iliac artery and muscle graft surgeries.

Gluteal compartment syndrome caused by traumatic rupture of the superior gluteal artery

<p>Introduction. We report a case of a sixty-year-old man diagnosed with glutealcompartment syndrome caused by traumatic rupture of the superior glutealartery associated with fracture of the inferior pubic ramus and blunt trauma.Case report. A patient was injured falling from a height of four meters. Signsof compartment syndrome and sciatic nerve compression developed threehours after the injury. The patient went through a computerized tomography(CT) scan procedure with contrast, which showed a hematoma in the glutealregion, but without signs of active bleeding. However, after observation andmonitoring of the patient, CT angiography was performed which revealeda rupture of the superior gluteal artery. Fasciotomy and debridement wereperformed and the patient was diagnosed with gluteal compartment syndromeand rupture of the superior gluteal artery. Surgery resulted in a significantimprovement of the patient’s condition.Conclusion. Traumatic gluteal compartment syndrome is a rare condition.Gluteal compartment syndrome should be taken into consideration in eachpatient with pelvic trauma and hematoma in the gluteal region whose neurologicalstatus is affected. Prompt diagnosis and fasciotomy are crucial inthe treatment and fasciotomy presents the gold standard in the treatment.</p>

Sonographic Diagnosis of a Superior Gluteal Artery Arteriovenous Fistula and Pseudoaneurysm After Bone Marrow Biopsy

Journal of Ultrasound in MedicineVolume 35, Issue 5 p. 1104-1106 Clinical Letters Sonographic Diagnosis of a Superior Gluteal Artery Arteriovenous Fistula and Pseudoaneurysm After Bone Marrow Biopsy Woon Teck Yap PhD, Woon Teck Yap PhD Department of Radiology, Stanford University Medical Center, Stanford University, Stanford, California USASearch for more papers by this authorR. Brooke Jeffrey MD, R. Brooke Jeffrey MD Department of Radiology, Stanford University Medical Center, Stanford University, Stanford, California USASearch for more papers by this author Woon Teck Yap PhD, Woon Teck Yap PhD Department of Radiology, Stanford University Medical Center, Stanford University, Stanford, California USASearch for more papers by this authorR. Brooke Jeffrey MD, R. Brooke Jeffrey MD Department of Radiology, Stanford University Medical Center, Stanford University, Stanford, California USASearch for more papers by this author First published: 01 May 2016 https://doi.org/10.7863/ultra.15.08048Citations: 3Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume35, Issue5May 2016Pages 1104-1106 RelatedInformation

Clinical characteristics of latent artery injury in orthopaedics and the efficiency of intra-arterial therapy

Objective To observe clinical characteristics of orthopaedic patients with latent artery injury and evaluate the efficiency of intra-arterial therapy. Methods Data of 13 orthopaedic patients with latent vascular injury who were enrolled in our hospital from June 2010 to October 2014 were retrospectively analyzed. There were 9 males and 12 females with an average age of 45.6 years(19-75 years). The affected arteries included superior gluteal artery (4 cases), obturator artery (2 cases), subclavian artery (2 cases), femoral profound artery (2 cases), femoral artery (1 case), popliteal artery (1 case) and brachial artery (1 case). According to the classification of systematic arterial injuries by Zhang Yingze, there were 6 cases of Type B and 7 cases of Type C. All patients were comfirmed by angiography with an average time of 16 hours (2-70 h) from primary injuries, and had undergone intra-arterial therapy with covered stent, spring coil and gelfoam. The functioning of arteries evaluated by ultrasound, CTA or DSA and the complication were recorded. Results Bleeding was successful controlled in 5 cases with covered stent, 5 cases with spring coil and 3 cases with spring coil and gelfoam. 7 cases with shock were improved immediately. 5 cases suffering lacunar infection were cured after repeated debridement. 1 case with popliteal artery rupture had amputation due to the long warm ischemia time. 1 case had gluteus muscular necrosis and secondary MODS, but recovered after treatment. All patients were followed up for 3-24 months with an average period of 7.3 months. No displacement of the stent, vascular occlusion and leakage were found. Conclusions Because latent artery injuries at an early stage are characterized by closure, delay and untypicality, they are often missed. Angiography is the gold standard for diagnosis. Intra-arterial therapy is an effective intervention for patients with latent non-major arterial injuries of Type B and C, and there are less recurrences and complications. Key words: Vascular system injuries; Endovascular procedures; Angiography

Application of intravascular interventional embolization in emergency treatment of hemodynamically unstable pelvic fracture

Objective To evaluate the value of intravascular interventional embolization in the emergency treatment of patients with hemodynamically unstable pelvic fracture. Methods The retrospective analysis was made on the medical records of 45 cases treated from October 2012 to December 2014. There were 27 male and 18 females(39.2±10.3) years (range, 28-54 years). Time from injury to admission was within 3 h. Injury severity score (ISS) was (25.3±8.1)points. The pelvic fracture included 32 cases of Type B and 13 Type C according to Tile classification system. After admission, anti-shock treatment and pelvic immobilization with the belt or external fixator were performed, and emergent intravascular interventional embolization was used to stanch bleeding after the bleeding of other organs was excluded. Vascular intervention, post-treatment vitazl signs and prognosis were evaluated. Results Time from admission to interventional therapy was 1.2-2.7 h[(1.9±0.8)h]. Time of interventional treatment was 1.6-3.2 h [(2.3±0.6)h]. Of the 45 cases, contrast extravasation was seen in 38 cases, abnormal vascular morphology in 5 cases, no obvious bleeding in 1 case, and contrast extravasation in the angiographic venous phase in 1 case. Among the 38 cases of contrast extravasation, the offending vessels involved were internal pudenda artery (26 cases), obturator artery (16 cases), superior gluteal artery (4 cases), inferior gluteal artery (4 cases), inferior epigastric artery (1 case) and external iliac artery (1 case), but 8 cases were noted to have two offending vessels and 1 case had delayed bleeding. Of the 45 cases, the hemostatic effect was good in the early stage. After the interventional embolization therapy, the heart rate was (105.2±14.8) beats/min, arterial pressure was (79.0±10.6)mmHg, central venous pressure was (5.1±0.8)cmH2O, and shock index was 1.1±0.5, showing improved vital signs postoperatively (P<0.05). Four cases died mainly due to the multiple organ failure. One case had abdominal distention aggravated 3 days after operation, which were confirmed to be bleeding in the branch of external iliac artery, and the symptom was alleviated after embolization therapy. Forty-one cases survived with ICU length of stay of (14.5±5.4) d, hospitalization time of (35.2±12.8) d and medical expense of (96, 755.3±20, 568.1) CNY. Conclusion In the emergency treatment of patients with hemodynamically unstable pelvic fracture, the intravascular interventional embolization has become an important measure of comprehensive treatment that allows fast and mini-invasive procedure hemostasis, and deserves clinical promoting. Key words: Hemodynamics; Pelvis; Fractures; Embolization, therapeutic

The evaluation of dorsogluteal and ventrogluteal injection sites: a cadaver study.

The aim of this study is to measure the thickness of the muscles in the dorsogluteal and the ventrogluteal injection sites and to determine which injection site is farther away from the neurovascular structures. Although the dorsogluteal region is frequently used for intramuscular injections, the ventrogluteal region is suggested as a more secure injection site due to its distance to the neurovascular structures. However, there are no measurements regarding the distances of these structures. Due to this reason, the distance between these injection sites and the neurovascular structures should be measured. This study is a descriptive study that used cadavers to measure the distance between the injection sites and the neurovascular structures. The study was conducted on 29 cadavers fixed with 10% formalin. The needle was advanced until reaching its end point. A 1·5-inch needle was used for the injections in both regions. The gluteal region was dissected. Parameters were measured with a digital vernier calliper. Data Analysis was performed using spss and the Wilcoxon Signed-Rank Test was used to examine differences among measurements from the two injection regions. Data were collected between February and May 2014. Sum of the thickness of the muscles is greater in the dorsogluteal region. The ventrogluteal region is farther than the dorsogluteal region from neurovascular structures. For the ventrogluteal injection administered from the same side, total thickness of the muscle was 22·22 ± 5 mm, distance to the superior gluteal artery was 13·87 ± 16 mm and distance to the superior gluteal nerve was 11·82 ± 14 mm. For the dorsogluteal injection, total thickness of the muscle was 28·35 ± 7 mm, distance to the superior gluteal artery was 6·83 ± 9 mm, and distance to the superior gluteal nerve was 5·67 ± 9 mm. Intramuscular injections must be based on an individual clinical assessment of each patient. The ventrogluteal region is preferred as the first-choice injection site. A needle of recommended length should be used to reach the target muscle.

Management of Sacral Pressure Sore by Clinically Isolated Superior Gluteal Artery Perforator-based Fasciocutaneus Flap in Patients with Spinal Cord Injury

Abstract Prolong confinement to bed in spinal injury patients imparts constant pressure on bony prominences resulting impairment of blood flow to local tissue. Constant pressure of 2 hours or more produces irreversible changes leading to tissue necrosis and development of pressure sore. Sacrum encounters highest pressure in supine position and is the commonest site of pressure sore in spinal cord injury patients followed by trochanter and heel. Objective of the study Observation on management of sacral pressure sore by superior gluteal arterial perforatorbased flap using anatomical land marks in the absence of facility of Doppler probe for isolation of superior gluteal arterial perforators. Materials and methods Thirteen patients of spinal cord injury presented with sacral pressure sore were managed surgically using superior gluteal artery perforator-based flap coverage. The location of the artery was identifi ed using anatomical land marks. In 10 patients the flap was heeled uneventfully, one had signifi cant complication with wound dehiscence. Conclusions Management of sacral pressure sore by superior gluteal arterial perforator-based flap using anatomical land marks is a simple and reliable procedure. The learning curve is not that stiff. Sophisticated instruments are not required for this procedure.

The dog-ear flap as an alternative for breast reconstruction in patients who have already undergone a DIEAP flap

Breast reconstruction in patients who have previously undergone deep inferior epigastric artery perforator flap (DIEAP) reconstruction or abdominoplasty is often challenging. Depending on patients' body habitus, several second-choice flaps have been described such as the transverse upper gracilis (TUG) flap, profundus femoris artery perforator (PFAP) flap, superior gluteal artery perforator (SGAP) flap, and lumbar artery perforator (LAP) flap. Patients who have undergone a DIEAP flap reconstruction or abdominoplasty occasionally present with dog ears on both sides of the abdominal scar. The adipose tissue and skin of these dog ears are supplied by perforators of the deep circumflex iliac artery (DCIA). The DCIA flap was first described in 1979 by Taylor. We introduce this abdominal "dog-ear" flap for autologous breast reconstruction.

Scar Wars: Preferences in Breast Surgery.

BackgroundThe uptake of breast reconstruction is ever increasing with procedures ranging from implant-based reconstructions to complex free tissue transfer. Little emphasis is placed on scarring when counseling patients yet they remain a significant source of morbidity and litigation. The aim of this study was to examine the scarring preferences of men and women in breast oncoplastic and reconstructive surgery.MethodsFive hundred men and women were asked to fill out a four-page questionnaire in two large Irish centres. They were asked about their opinions on scarring post breast surgery and were also asked to rank the common scarring patterns in wide local excisions, oncoplastic procedures, breast reconstructions as well as donor sites.ResultsFifty-eight percent of those surveyed did not feel scars were important post breast cancer surgery. 61% said that their partners' opinion of scars were important. The most preferred wide local excision scar was the lower lateral quadrant scar whilst the scars from the deep inferior epigastric artery perforator (DIEP) flap were most favoured. The superior gluteal artery perforator flap had the most preferred donor site while surprisingly, the DIEP had the least favourite donor site.ConclusionsScars are often overlooked when planning breast surgery yet the extent and position of the scar needs to be outlined to patients and it should play an important role in selecting a breast reconstruction option. This study highlights the need for further evaluation of patients' opinions regarding scar patterns.

Internal Iliac Aneurysm Repair Outcomes Using a Modification of the Iliac Branch Graft

Iliac branch grafts (IBGs) are a validated option for the treatment of aorto-iliac aneurysms preserving internal iliac artery (IIA) flow. IIA aneurysm (IIAA) is a relative contraindication to IBG placement. The goal of this study was to review experience in managing aorto-iliac aneurysms with concomitant IIAAs with extension of the IIA branch stent graft into the superior gluteal artery (SGA). This retrospective study between May 2009 and November 2014 includes consecutive patients who underwent placement of an IBG (Cook, Bloomington, IN, USA) with extension of the internal iliac component of the branch stent graft into the SGA because of aneurysmal IIA (>15 mm). The stent grafts used were Viabahn (Gore, Karlsruhe, Germany), Fluency (Bard, Flagstaff, AZ, USA), or iCast (Atrium, Hudson, NH, USA) proximally. Imaging follow up was with computed tomography angiography (CTA) within 30 days of device insertion and then annually. The procedure was performed on 15 patients with a mean age of 76.8 years (SD 6.1 years). Twenty IIAAs were treated with a mean IIA and common iliac artery (CIA) diameter of 33 mm (SD 13 mm) and 35 mm (SD 11 mm) respectively. Technical success rate was 100%. One patient who underwent simultaneous IBG and three vessel fenestrated endovascular aneurysm repair died of mesenteric ischemia 2 days after the procedure. Mean imaging follow up with CTA was 18.3 months (SD 15.1 months). Primary patency of the SGA stent grafts was 100%. There was one case of type II endoleak. All patients were free from buttock claudication at follow up (mean: 19.7 months). Two patients who had IIA embolization contralateral to the IBG placement suffered from unilateral lower limb monoparesis. Extension of the internal iliac component of IBGs into the SGA for distal seal is feasible and safe in the endovascular treatment of aorto-iliac aneurysms with concomitant IIAs. Long-term results are needed to further validate this technique.

Covered Stent in the Superior Gluteal Artery in a Hybrid Approach to Treat Internal Iliac Artery Aneurysm: A Technical Note

This brief report describes a hybrid endovascular and open procedure to treat internal iliac artery (IIA) aneurysms and preserve pelvic blood flow. A covered stent was deployed before surgery in the superior gluteal artery, extending across the IIA aneurysm, with the proximal end in the common iliac artery lumen. During open aortoiliac aneurysm repair, the stent graft was anastomosed in an end-to-side manner to the surgical graft. Four aneurysms were treated in 3 patients. Technical success was achieved in all cases. There were no complications or repeat interventions. Stents were all patent at imaging follow-up (range, 6–25 mo). Patients were free from buttock claudication.

Comprehensive Evaluation of Risk Factors and Management of Impending Flap Loss in 2138 Breast Free Flaps.

Loss of a breast free flap is a relatively rare but catastrophic occurrence. Our study aims to identify risk factors for flap loss and to assess whether different salvage techniques affect flap salvage. We performed a retrospective review of all breast free flaps performed at a single institution from 2000 to 2010. Overall, 2138 flaps were performed in 1608 patients (unilateral, 1120 and bilateral, 488) with 44 flap losses (2.1%). Age, body mass index, smoking, radiation, chemotherapy, and surgeon experience did not affect flap loss. Abdominal flaps based on a single perforator were at significantly higher risk for flap loss compared with flaps based on multiple perforators (P = 0.0007). Subgroup analysis of the subset of 166 compromised free flaps (flaps requiring a return to the operating room, an intraoperative anastomotic revision, or loss/partial loss of a free flap) demonstrated deep inferior epigastric perforator, and other flaps (superficial inferior epigastric artery and superior gluteal artery perforator) were significantly associated with flap loss [odds ratio (OR) 5.20; P = 0.03 and OR 6.91; P = 0.0004, respectively] compared with transverse rectus abdominis myocutaneous and muscle-sparing transverse rectus abdominis myocutaneous flaps. Although an intraoperative complication was not associated with a flap loss, the need for a reoperation was strongly predictive (P < 0.0001). Flap salvage was the highest within the first 24 hours (83.7%) and significantly less between days 1 and 3 (38.6%; P < 0.0001) and beyond 4 days (29.4%; P < 0.0001). Longer ischemia time was significantly associated with flap loss (P = 0.04). Salvage techniques (aspirin, heparinzation, thrombectomy, and thrombolytic) had no impact on flap salvage rates. Heparinization and thrombolytics were associated with higher loss rates (OR 3.40; P = 0.003 and OR 10.36; P < 0.0001, respectively). Free flap loss following breast reconstruction is multifactorial with higher losses in superficial inferior epigastric artery and gluteal flaps, single-perforator abdominal flaps, and longer ischemia times. Salvage rates are most successful within the first 24 hours, and the use of heparinization, aspirin, and thrombolytics does not improve salvage rates.

Porcine model for free-flap breast reconstruction training

Free-flap breast reconstruction is a challenging surgical procedure with a steep learning curve. A reproducible large animal model could be relevant for free-flap harvesting and microsurgical anastomosis training. The aim of this study was to assess the feasibility of a porcine model for free-flap breast reconstruction. Three female pigs were placed under general anesthesia in order to study feasibility and estimate relevance for training. The deep inferior epigastric perforator (DIEP) flap, the transverse musculocutaneous gracilis (TMG) flap, and the superior gluteal artery perforator (SGAP) flap were harvested and anastomosed to the internal thoracic vessels. Differences were noted between pig and human anatomy, and the surgical procedure was adapted to build training models. Under a more prominent anterior thoracic wall, the internal thoracic vessels were slightly deeper and larger than in human anatomy. The DIEP flap was never feasible in the porcine model. However, the superior epigastric artery perforator (SEAP) flap showed anatomical similarity with the human DIEP flap, and it proved to be suitable for an inverted training model. The porcine TMG flap harvesting was close to the human one, reproducing specific dissection and anastomotic difficulties. The SGAP flap was not a muscular perforator flap in pigs but a septocutaneous flap. Because of the thinness of the hypodermal fat, porcine flaps were not considered adequate training models for breast-mound shaping. Despite any anatomical variations, the pig has proven to be a suitable training model for free-flap harvesting and transfer in the field of breast reconstruction.

Reliable transfer of multiple perforator-based pedicled flaps: Surgical technique and clinical outcomes.

Although an increase in flap perfusion by incorporating multiple perforators has been demonstrated with free perforator flaps, whether the same efficacy can be achieved with pedicled flaps remains unclear, due to concerns regarding pedicle tension or kinking during flap transposition. The aim of this report was to investigate the reliability of multiple perforator-based pedicled flaps in a series of clinical cases. Twenty-six patients undergoing soft tissue reconstruction using multiple perforator-based pedicled flaps from 2008 to 2012 were reviewed. The causes of the defects were oncologic (n = 15) or chronic wounds (n = 11). The defect sites were the trunk (n = 19), lower extremities (n = 4), head and neck (n = 2), and upper extremities (n = 1). Diverse flap types were used, including the superior gluteal artery perforator flap, the lateral femoral circumflex artery perforator flap, the medial femoral circumflex artery perforator flap, and the thoracodorsal artery perforator flap. The flaps were transposed in a rotation-and-advancement manner after skeletonizing each perforator and proximally dissecting the pedicle. The donor site was closed primarily. Mean flap size was 125.2 cm2 , and the mean number of perforators used was 2.3 (2-5). The mean angle of pivotal rotation for flap transposition was 132.8°. No rotation-related problems including pedicle kinking or twisting developed, and all flaps survived completely. No significant donor-site morbidity was observed. The mean follow-up period was 38.1 months. This report suggests that through meticulous dissection of pedicles of sufficient length, the multiple perforator-based pedicled flaps can be successfully transposed while minimizing the risk of pedicle tethering. © 2015 Wiley Periodicals, Inc. Microsurgery 37:105-111, 2017.

Feasibility of a Deepithelialized Superior Gluteal Artery Perforator Propeller Flap for Various Lumbosacral Defects

Skin and soft tissue defects in the lumbosacral area are commonly encountered in the field of reconstructive surgery, and it is well documented that the superior gluteal artery perforator (SGAP) flap provides excellent coverage of these defects. In this article, we describe our experience using a modified version of the SGAP propeller flap, in which the distal redundant portion of an elevated SGAP flap is deepithelialized, thereby maximizing the effect of the soft tissue augmentation. Thirteen patients with lumbosacral soft tissue defects treated between May 2010 and June 2012 were included in this study. The wound causes were pressure ulcer (n = 9), pseudomeningocele (n = 2), and hardware exposure (n = 2). In all patients, an elevated SGAP flap was rotated 180 degrees over the defect area and the extra distal portion of the flap was deepithelialized and used as a soft tissue filler or tamponade. During the follow-up period (mean, 26 months), 12 of 13 flaps survived completely. One flap was totally necrosed due to progressive venous congestion and was reconstructed with local advancement flaps. No further complications were noted. Because of the redundancy and pliability of the tissue in the gluteal area, a flap relatively wider or longer than the defect can be elevated safely. Hence, the redundant tissue volume can be tucked inside to facilitate soft tissue augmentation of the area. We propose that the deepithelialized version of the SGAP propeller flap is an effective option for the reconstruction of various lumbosacral soft tissue defects because it offers thick and healthy soft tissue from a distant site to the defect areas.