Pedicled Fasciocutaneous Flap of Multi-island Design for Large Sacral Defects

We designed a new pedicled fasciocutaneous flap for large sacral defects that combined a classic superior gluteal artery perforator flap and an acentric axis perforator pedicled propeller flap. We asked whether this technique would be simple and result in few complications. Six patients with large sacral defects had reconstruction using this technique in one stage. The size of the defect and postoperative complications in each patient were assessed. The minimum followup was 6 months (mean, 20.1 months; range, 6-38 months). All wounds healed with no recurrence during followup. Five patients achieved healing primarily, and another with minimal drainage achieved healing by secondary intention after a dressing change. No patients had deep infection, wound dehiscence, necrosis, or partial loss or shrinkage of the flap at final followup. The buttocks were symmetric. We consider this a good alternative for reconstructing large sacral defects because it is a relatively simple procedure and results in few complications. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.