scholarly journals Perianal Circumferential Reconstruction with Tailored Superior Gluteal Artery Perforator Flap

2020 ◽  
Vol 25 (4) ◽  
pp. 304-308
Author(s):  
Jeehyun Moon ◽  
Kyeong Tae Lee
Keyword(s):  
Perforator Flap ◽  
Good Option ◽  
Wide Excision ◽  
General Surgeon ◽  
Anal Function ◽  
Superior Gluteal Artery ◽  
Wound Contamination ◽  
Artery Perforator ◽  
Sgap Flap

Reconstruction following wide excision of perianal lesion is challenging as it requires resistance to high risks of wound contamination and preservation of anal function. Here, we present a case of a unilateral superior gluteal artery perforator (SGAP) flap with an opening in the flap. A 77-year old woman was referred due to an extramammary Pagets disease encircling the anus. Wide excision was performed by the general surgeon team, which generated a circumferential perianal defect. A unilateral SGAP flap was elevated. Primary defatting was done and an opening was made at the proper location of the anus. The anal mucosa was pulled out through the hole and sutured to the flap. She was discharged without any complications. At the follow-up visit, preservation of postoperative anal functions, as well as satisfactory contour, were observed. A well-tailored unilateral SGAP flap may be a good option for reconstruction of a perianal defect encircling the anus.

scholarly journals Long-term follow-up of superior gluteal artery perforator flap closure of large myelomeningoceles

2017 ◽  
Vol 19 (3) ◽  
pp. 333-338 ◽  
Author(s):  
Brett A. Whittemore ◽  
Dale M. Swift ◽  
Bradley E. Weprin ◽  
Frederick J. Duffy
Keyword(s):  
Perforator Flap ◽  
Surrounding Tissue ◽  
Tissue Quality ◽  
Superior Gluteal Artery ◽  
Flap Technique ◽  
Long Term Follow Up ◽  
Artery Perforator ◽  
Sgap Flap

OBJECTIVE Large myelomeningocele defects and poor surrounding tissue quality make some defects particularly difficult to close primarily. This paper describes the superior gluteal artery perforator (SGAP) flap technique for defect closure and long-term clinical outcomes. METHODS The technique for closing a myelomeningocele with an SGAP flap is described. A retrospective chart review was performed on a cohort of 11 patients who underwent closure in this manner. RESULTS Between 1999 and 2015, 271 myelomeningoceles were closed, 11 of which were SGAP flap closures. The mean defect size was 5.5 × 7.2 cm. All patients underwent ventriculoperitoneal shunting. There were no cases of CSF infection. Five patients had minor wound issues (small dehiscence or eschar formation) that healed satisfactorily. Two patients had soft-tissue wound infections and required multiple revisions; one patient had multiple severe developmental abnormalities, and the other patient's flap had healed with a thick underlying fat pad 4 months postoperatively. No patients had significant surgical site pain on long-term follow-up. CONCLUSIONS The SGAP flap technique achieves tension-free closure with vascularized, fat-bearing full-thickness skin. It is useful for closure of large, complex defects, is not associated with chronic pain, and carries a morbidity risk that is comparable to other complex myelomeningocele closure techniques.

Outcome of Closure of Wide Based Defects by Various Rotational Flaps

2021 ◽  
Vol 15 (9) ◽  
pp. 2268-2269
Author(s):  
Muhammad Sohaib Anwer ◽  
Faisal Waheed ◽  
Atta Ur Rehman Khan ◽  
Sana Ullah ◽  
Naeem Ul Haq ◽  
...  
Keyword(s):  
Perforator Flap ◽  
Wound Dehiscence ◽  
Distal Portion ◽  
Lumbosacral Region ◽  
Superior Gluteal Artery ◽  
Dural Sac ◽  
Superficial Wound ◽  
Study Setting ◽  
Artery Perforator ◽  
Tissue Defects

Aim: To observe the outcome of closure of wide based defects by various rotational flaps for meningomyelocele defects. Study setting: Neurosurgery Department, Sheikh Zayed Hospital, Rahim yar khan Duration: From Oct 2018 to Oct 2020, Methodology: We included 15 patients with wide based myelomeningocele anomalies in the neurosurgery department, Sheikh Zayed Hospital, Rahim yar khan. Age ranged from four days to eight years. The flaw had a diameter of between 8x5cm and 12x8cm. Rotational flaps were used to restore soft tissue defects in all cases. Result: In this study, we did posterior intercostal artery perforator flap(superiorly based) in 40% patients, double rotation flap (yin yang) in 26.7% patients, superior gluteal artery perforator flap in 20 % patients and z plasty in 13.3 % patients. Regarding complications, 2 (13.3%) individuals had a superficial wound dehiscence. One individual (6.7%) developed necrosis of the distal portion of the flap, which was conventionally handled. Postoperatively, no neurosurgical problem occurred. After an average of 6 months, no patient experienced reappearance or dural sac herniation. Conclusion: Restoration of large meningomyelocele defects using local rotational flaps is a secure and reliable approach for abnormalities in the lumbosacral region. Keywords: Meningomyelocele, rotational flaps

Superior Gluteal Artery Perforator Flap: A Reliable Method for Sacral Sores

2018 ◽  
Vol 9 (2) ◽  
pp. 178-183
Author(s):  
Vikas Kakkar ◽  
◽  
Gurlal Singh Pura ◽  
Harpreet Singh ◽  
Balcharan Singh Bajwa ◽  
...  
Keyword(s):  
Reliable Method ◽  
Perforator Flap ◽  
Superior Gluteal Artery ◽  
Artery Perforator

Free superficial circumflex iliac artery perforator flap with a single-pedicle bilobed design for pediatric multi-digit defect reconstruction

2020 ◽  
Author(s):  
Zhangcan Li ◽  
Dawei Zheng ◽  
Jian Zheng ◽  
Weiya Qi ◽  
Qiang Qi ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Pediatric Patients ◽  
Color Doppler ◽  
Perforator Flap ◽  
Interphalangeal Joint ◽  
Soft Tissue Reconstruction ◽  
Tactile Sense ◽  
Defect Reconstruction ◽  
Artery Perforator

Abstract Objectives: This paper describes imaging and anatomical features, in order to assess the feasibility of superficial circumflex iliac artery perforator (SCIP) flap with a single-pedicle bilobed design for multi-digit skin and soft tissue reconstruction in pediatric patients.Methods: A total of 7 pediatric patients who were being treated with free single-pedicle bilobed SCIP flap reconstruction for multi-digit defects were included in this study. The details of the clinical features were collected, and the following were successively analyzed: the preoperative Computed Tomographic Angiography (CTA) and Color Doppler Sonography (CDS) examinations for flap design, the intraoperative anatomy for perforator vessel, defect reconstruction and interphalangeal range of motion (ROM) and tactile sense, pain sense and two-point discrimination recovery results.Results: CTA and CDS performed preoperatively could accurately and rapidly identify the position, location and course of the SCIP flap. All wounds healed by the first follow-up and no complications occurred at the follow-up visit. All flaps survived, the patients achieved proximal interphalangeal joint (PIP) ranges of motions (ROM) from 80 to 100 degree and distal interphalangeal joint (DIP) ROM from 65 to 80 degree. The tactile sense and pain sense recovered, and average of the two-point discrimination scores was 9.3mm (range 7-12mm). The donor area was primarily sutured with good scar concealment in the underwear region.Conclusion: CTA and CDS performed preoperatively are accurate and intuitive methods for assessing the location and course of SCIP. The SCIP flap is highly suitable for pediatric patients due to its small caliber, specific functional and aesthetic benefits. It can be designed in a lobulated fashion in order to repair two or more wounds during one surgery. We suggest that the free single-pedicle bilobed SCIP flap should be considered an optimal choice for multi-digit defect reconstruction in pediatric patients in the clinic.

Der „Superior Gluteal Artery Perforator Flap“ (S-GAP-Flap)

2002 ◽  
Vol 34 (4) ◽  
pp. 257-261 ◽  
Author(s):  
A.-M. Feller ◽  
I. Richter-Heine ◽  
K.-D. Rudolf
Keyword(s):  
Perforator Flap ◽  
Superior Gluteal Artery ◽  
Artery Perforator

The Use of Magnetic Resonance Imaging in Planning a Pedicled Perforator Flap for Pressure Sores in the Gluteal Region

2018 ◽  
Vol 17 (2) ◽  
pp. 106-112
Author(s):  
Sun-June Park ◽  
Kyeong-Tae Lee ◽  
Byung-Joon Jeon ◽  
Kyong-Je Woo
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Perforator Flap ◽  
Gluteal Region ◽  
Pressure Sores ◽  
Resonance Imaging ◽  
Inferior Gluteal Artery ◽  
Perforator Flaps ◽  
Superior Gluteal Artery ◽  
Artery Perforator

Pedicled perforator flaps (PPFs) have been widely used to treat pressure sores in the gluteal region. Selection of a reliable perforator is crucial for successful surgical treatment of pressure sores using PPFs. In this study, we evaluate the role of magnetic resonance imaging (MRI) in planning PPF reconstruction of pressure sores in the gluteal region. A retrospective chart review was performed in patients who had undergone these PPF reconstructions and who had received preoperative MRI. Preoperatively, the extent of infection and necrotic tissue was evaluated using MRI, and a reliable perforator was identified, considering the perforator location in relation to the defect, perforator size, and perforator courses. Intraoperatively, the targeted perforator was marked on the skin at the locations measured on the MRI images, and the marked location was confirmed using intraoperative handheld Doppler. Superior gluteal artery, inferior gluteal artery, or parasacral perforators were used for the PPFs. Surgical outcomes were evaluated. A total of 12 PPFs were performed in 12 patients. Superior gluteal artery perforator flaps were performed in 7 patients, inferior gluteal artery perforator flaps were performed in 3 patients, and parasacral perforator flaps were performed in 2 patients. We could identify a reliable perforator on MRI, and it was found at the predicted locations in all cases. There was only one case of partial flap necrosis. There was no recurrence of the pressure sores during the mean follow-up period of 6.7 months (range = 3-15 months). In selected patients with gluteal pressure sores, MRI is a suitable means for not only providing information about disease extent and comorbidities but also for evaluating perforators for PPF reconstructions.

Clinical experience with the lateral septocutaneous superior gluteal artery perforator flap for autologous breast reconstruction

Microsurgery ◽  
2010 ◽  
Vol 30 (5) ◽  
pp. 339-347 ◽  
Author(s):  
Ariel N. Rad ◽  
Jaime I. Flores ◽  
Roni B. Prucz ◽  
Sahael M. Stapleton ◽  
Gedge D. Rosson
Keyword(s):  
Breast Reconstruction ◽  
Clinical Experience ◽  
Perforator Flap ◽  
Autologous Breast Reconstruction ◽  
Superior Gluteal Artery ◽  
Artery Perforator
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