The sacral ulcerations of these 30 patients successfully treated with debridement and immediate or delayed reconstruction using SGAP flaps.
After debridement, a SGAP flap measuring 8 cm x 12 cm based on one perforator was moved into the defect beneath the skin strip and inset without any tension.
After debridement, a 13 cm x 7 cm SGAP flap was designed to cover the defect.
sup] described the use of the SGAP flap, based on the perforator arising from the SGA that penetrates the gluteus maximus muscle, to reconstruct a large midline sacral defect.
In our series, however, we planned the flap to be 2 cm longer than the defect around the predetermined perforator vessels to make the SGAP flap as an ellipse fit the sacral defect.
We choose the medial perforator vessel as a pivot point to rotate the SGAP flap and found no need to skeletonize the perforator.
We think there are several reasons why our SGAP flaps could cover the sacral sores without needing a long pedicle dissection,
The SGAP flaps are relative technique-demanded and meticulous dissection of the perforators is to achieve a good surgical result.
Nowadays, many plastic surgeons consider the pedicled SGAP flap to be the flap of choice for sacral pressure sores.
The pedicled SGAP flap, being a fasciocutaneous flap, lacks muscle 'cushioning' and continued pressure over it will lead to recurrence of the sore.
The pedicled SGAP flap is muscle-sparing and therefore beneficial in ambulatory patients.
Complete flap survival with stable wound coverage, muscle-sparing properties for future reconstructive options, minimal intra-operative blood loss and minimal donor site morbidity make the pedicled SGAP flap a reliable option for sacral pressure sore reconstruction.