Versatility of the Limberg flap and the V-Y flap (based on a distal perforator) for covering sacral ulcers.

Our simple criteria for selection of two efficient flaps achieves consistently good results for most sacral ulcers. One hundred and ten patients had their sacral ulcers reconstructed with the Limberg flap (n = 48) or the distal-perforator-based V-Y (DPVY) flap (n = 62). The criteria for selection were based on pinching of the donor skin to estimate the feasibility of the Limberg flap. Overall, 101/110 (92%) of the flaps healed primarily, 43/48 (90%) in the Limberg flap group, and 58/62 (94%) in the DPVY flap group. The advantages of reconstruction using our two flaps include simple and consistent design of, and procedure for, both flaps, wide excursion of the DPVY flap, and consistency of the surgeons' skill because they used only two flaps.