PERFORATOR-BASED FLAP FOR COVERAGE OF LUMBOSACRAL DEFECTS

Lumbosacral defects on 20 patients were covered with a perforator-base d flap. Cutaneous perforators derived from the 9th and 10th intercosta l arteries, the 4th lumbar artery, and multiple gluteal perforators th at penetrate the gluteus maximus muscle were used as vascular pedicles . Minor complications occurred in five cases. Using this method, minim al morbidity of the donor site is expected because the gluteus maximus need riot be sacrificed. Accordingly, perforator-based flaps are espe cially indicated for ambulatory patients, but for paraplegic patients as well. Even in the event of recurrence, another perforator-based or musculocutaneous flap can be elevated fr om the ipsilateral side becau se of the presence of multiple perforators in the lumbosacral and glut eal regions.