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Back to 2017 Program


The Pedicled Superior Gluteal Artery Perforator Flap for Coverage of Sacral Pressure Ulcers - Clinical Review and Technical Considerations
Tamara L. Kemp, MD1, David Mathes, MD2.
1University of Washington, Seattle, WA, USA, 2University of Colorado, Aurora, CO, USA.

PURPOSE
Perforator-based fasciocutaneous flap reconstruction has become increasingly utilized for coverage of locoregional defects. We present our experience with the pedicled superior gluteal artery perforator flap (SGAP flap) for sacral ulcer reconstruction. We also review technical and anatomic concepts for its design and use.
METHODS
A retrospective review of patients who underwent flap coverage of sacral pressure ulcers at a single institution over a 6-year period. Patient demographic data, operative characteristics and flap outcomes were collected. Relevant comparisons between the SGAP flap and alternate gluteal-based flap reconstructions were made.
RESULTS
Of 83 gluteal-based flaps performed during the study period, 12 were SGAP flaps. Rates of perioperative complications in the series of SGAP flaps, including minor suture line dehiscence (41.6 percent), hematoma (<1 percent), infection (zero), and same-site site recurrence (16.6 percent), were consistent with, or lower than those of all alternate gluteal flap types (41.7 percent, 9.7 percent, 12.5 percent, and 23.6 percent respectively) (Table 3). All 12 SGAP flaps in our series were ultimately successful in providing sacral ulcer coverage and healing.
CONCLUSIONS
The pedicled SGAP flap is a safe, reliable option for reconstruction of sacral pressure ulcer defects. It embodies the key principles of pressure ulcer reconstruction in that it is simply designed, reliable, reusable, and minimizes donor site morbidity. The SGAP flap should be included in the current surgeon’s armamentarium of flaps for sacral ulcer reconstruction.


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