(Superior Gluted Artery) S-GAP V-Y rotation advancements flap for large sacral pressure sores.

Objective: To stress the superb utility and easy movement of gluteal soft tissue in reconstruction of sacral pressure sores, while preserving further options for future use, in multiply moribund patients. Study Design: Retrospectively analyzed. Setting: Department of Plastic Surgery, Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan. Period: November 2019 till March 2022. Methods: Twenty-seven patients were retrospectively analyzed, who underwent coverage of moderate to large grade III and IV, sacral pressure sores with 28 V-Y rotation advancement flaps based on superior gluteal artery perforator. The cause of injury, demographic details, and wound characteristics were obtained from patient records. Results: The study included 24 men and 3 women, with mean age of 31 years, including three children. Spinal injury secondary to road traffic accident was the most common cause of spinal injury followed by firearm injury and meningomyelocele. Patients were followed for 6 months to one year. All flaps survived completely, with one incidence of dehiscence which was managed by delayed closure, with readvancement. Conclusion: Among the many strategies for sacral pressure sore coverage, perforator-based movement of gluteal soft tissue is very reliable, easy to master and lends itself to reuse in future circumstances.