Perforator based flaps for sacral pressure sore A change from convention

Pressure sore reconstruction has always been a challenge for plastic surgeons due to its recurrence. Traditional local fasciocutaneous musculocutaneous flaps have been associated with high recurrence rate and high morbidity. With the advent of the perforator-based fasciocutaneous flaps, the gluteal artery perforator have become a new and exciting entity with minimum morbidity and multiple options of reconstruction for recurrent problems.This Study was conducted in our institute in patients who were admitted for the sacral pressure sore management due to various causes during the period from May 2012 to May 2013. This study presents a series of 8 cases (5 male, 3 female) of perforator-based fasciocutaneous flaps for sacral pressure sore reconstruction. The flaps were used as a propeller to obliterate the defects. 6 of 8 flaps healed uneventfully without any complications. One patient had a flap that partially necrosed. One case the flap totally necrosed. There was no recurrence during the follow up of 6 months period. We have modified our flap by limiting the dissection to the pedicle. By doing so we can decrease the operative time considerably, reduce blood loss and inadvertent damage to the perforator. It can be even performed by surgeons without micro vascular training.