Stepladder V-Y advancement flaps for resurfacing various shaped defects of the sacrogluteal region

Gluteal stepladder V-Y advancement musculocutaneous and fasciocutaneous flaps were used for resurfacing of various shaped sacrogluteal defects. A total of 27 patients with sacrogluteal defects were treated using this technique. Twenty-four patients had sacral pressure sores, 2 patients had a pilonidal sinus, and 1 had a low thermal burn of the gluteal region. The shape of defects varied including 12 elliptic, 5 inverted heart-shaped, 4 pentagon, 4 diamond, and 2 other shapes. There were no problems regarding flap survival even at the tip of step segments. In all patients, easy resurfacing of the defects and satisfactory recontour of the gluteal region was obtained without linear scars crossing the gluteal fissure. Since the segments of the flap are similar to the defect, defects of various shapes are easily covered, and trimming of normal skin tissue becomes unnecessary or minimal. On inserting a triangular flap in the gluteal fissure, excellent recontour of the sacrogluteal region can be achieved. Received: 19 October 1998 / Accepted: 20 January 1999