Modification of the superior gluteal artery perforator flap for reconstruction of sacral sores

Chin-Ta Lin, Shun-Cheng Chang, Shyi-Gen Chen, Yuan-Sheng Tzeng

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Background: Despite advances in reconstruction techniques, the treatment of sacral sores remains challenging to plastic surgeons. The superior gluteal artery perforator (SGAP) flap is reliable and preserves the entire contralateral side as a future donor site. The ipsilateral gluteal muscle is preserved, and the inferior gluteal artery flaps are viable. However, dissection of the perforator is tedious and may compromise the perforator vessels. Methods: Between April 2003 and March 2013, we performed two modified flap-harvesting techniques: a rotational and a tunnel method, with only a short pedicle dissection to cover 30 sacral defects. Patient characteristics including sex, age, cause of sacral defect, flap size, perforator number, use and postoperative complications were recorded. Results: All flaps survived except two, which developed partial flap necrosis and were finally treated by contralateral V-Y advancement flap coverage. The mean follow-up period was 14.8 months (range, 3-24 months). No flap surgery-related mortality or recurrence of sacral pressure sores or infected pilonidal cysts were noted. Conclusions: Perforator-based flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscle. The advantages of our modification procedure include shorter operative time, lesser bleeding and lesser pedicle trauma, which make the SGAP flaps an excellent choice for sacral sore coverage. © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)526-532
Number of pages7
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Issue number4
Publication statusPublished - 2014
Externally publishedYes


  • Reconstruction
  • Sacral sore
  • Superior gluteal artery perforator flap
  • adult
  • aged
  • article
  • bleeding
  • clinical article
  • debridement
  • decubitus
  • female
  • gluteus maximus muscle
  • graft necrosis
  • human
  • ipsilateral gluteal muscle
  • island flap
  • male
  • middle aged
  • operation duration
  • plastic surgery
  • priority journal
  • sacrum pressure sore
  • superior gluteal artery perforator flap
  • surgical technique
  • very elderly
  • wound healing
  • young adult
  • Adult
  • Aged
  • Aged, 80 and over
  • Buttocks
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pressure Ulcer
  • Reconstructive Surgical Procedures
  • Surgical Flaps
  • Young Adult


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