GLUTEAL THIGH FLAP USED AS A FASCIOCUTANEOUS FREE-FLAP

The gluteal thigh flap is a myofascio-cutaneous flap receiving its blo od supply from a descending branch of the inferior gluteal artery. The gluteal thigh flap was first described by Hurwitz in 1980; since then numerous articles have reported on the successful use of this flap, a s a transposition or a pedicled island flap, to cover wounds in the sa crogluteal and perineal regions. In contrast to its widespread use as a pedicled flap, employment of the gluteal thigh flap as a free flap i s almost unreported in the literature, despite its extremely low donor morbidity and numerous articles on successful (other) free flap recon structions based on the (same) inferior gluteal artery (e.g., in breas t reconstruction). In this article we report on the successful use of the gluteal thigh flap as a purely fascio-cutaneous free flap in limb reconstruction. The literature on the microvascular anatomy of the glu teal thigh flap is reviewed in detail, and a precise description is gi ven of the preoperative measures and surgical manoeuvres required to i ncrease the reliability of this free flap. From the anatomical data an d the problems encountered in this case, it should be concluded that, despite the many advantages of this flap and an ultimately successful outcome, the gluteal thigh flap is not a first choice flap for microva scular transfer. (C) 1997 Wiley-Liss, Inc.