Modification of the gluteus maximus V-Y advancement flap for sacral ulcers: the gluteal fasciocutaneous flap method

Plastic and Reconstructive Surgery
H OhjimiI Haraga

Abstract

We designed a modified gluteus maximus V-Y advancement flap method for closing a sacral ulcer. The purposes of our method were to simplify the surgical procedure and to avoid a functional deficit of the gluteus maximus muscle that was sacrificed by the conventional method. After excising the sacral ulcer, the V-Y advancement flap is marked on the bilateral buttock. Fascial incision of the gluteus maximus is made at the same incision in the skin. One-third of each medial flap is elevated as a fasciocutaneous flap by dissecting the layer between the fascia and the muscle at the parasacral region. The flaps are then moved medially and sutured. We operated on 24 patients with sacral ulcers using this technique. The patients included 19 with a sacral pressure sore and 5 with a radiation ulcer on the sacrum. Eighteen ambulatory patients also were included in this group. The results showed no flap necrosis in any patient. No functional deficit of the gluteus maximus muscle was observed postoperatively in the ambulatory patients. Average blood loss was 250 ml during the procedure. We conclude that the gluteus V-Y advancement flap as a fasciocutaneous flap is superior to the conventional musculocutaneous flap method.

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Citations

Jun 11, 2005·Aesthetic Plastic Surgery·Sadri O SozerCoty Wolf
Mar 26, 1998·Plastic and Reconstructive Surgery·E Vaubel
Jun 5, 2002·Plastic and Reconstructive Surgery·Huseyin Borman, Tugrul Maral
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Nov 26, 2014·Journal of Plastic Surgery and Hand Surgery·Yen-Chang Hsiao, Shiow-Shuh Chuang
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Oct 7, 2004·Plastic and Reconstructive Surgery·Shigeru IchiokaTakashi Nakatsuka
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Jun 26, 2007·Annals of Plastic Surgery·Efstathios G LykoudisGeorgia-Alexandra Ch Spyropoulou
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Sep 3, 2014·Annals of Plastic Surgery·Giovanni Di CaprioFrancesco D'Andrea
Sep 12, 1998·Plastic and Reconstructive Surgery·C Hill, M Riaz

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