Durgun Mustafa, Bas Soysal
Department of Plastic, Reconstructive and Aesthetic Surgery, University of Medical Science, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
Ann Plast Surg. 2019 Mar;82(3):304-309. doi: 10.1097/SAP.0000000000001737.
Reconstructive choices for the defects of the sacral and ischial regions include various steps of the reconstructive ladder from primary closure to free flaps. This study aimed to present repair of sacral and ischial region defects with lateral sacral artery perforator (LSAP) flaps.
We enrolled a total of 18 patients with sacral and ischial region defects reconstructed with LSAP flaps in the study between September 2014 and October 2015. The patients were evaluated in terms of age, sex, neurological situation, etiology, defect size, defect region, flap size, perforator number, and postoperative complications.
No patient had hematoma, seroma, and complications of the donor area. In the postoperative period, 2 patients were observed to have short-term complications (11.1%) including a partial flap loss (5.5%) due to distal venous failure (flap survival rate, 95%) and a wound site infection (5.5%). Duration of follow-up of the patients ranged between 26 and 38 months. Recurrence was observed from long-term complications of 4 patients' pressure sores (22%).
The LSAP flap has not been frequently described in the literature. We believe that LSAP flap is a flap of choice that should be considered preferably for sacral and ischial defects, which can be reliably elevated over pedicles and has short surgery duration and low surgical morbidity.
骶骨和坐骨区域缺损的重建选择包括从一期缝合到游离皮瓣等重建阶梯的各个步骤。本研究旨在介绍采用骶外侧动脉穿支（LSAP）皮瓣修复骶骨和坐骨区域缺损。
2014年9月至2015年10月期间，我们共纳入了18例采用LSAP皮瓣重建骶骨和坐骨区域缺损的患者。对患者进行了年龄、性别、神经状况、病因、缺损大小、缺损区域、皮瓣大小、穿支数量及术后并发症等方面的评估。
无患者出现血肿、血清肿及供区并发症。术后，观察到2例患者出现短期并发症（11.1%），包括因远端静脉功能衰竭导致的部分皮瓣坏死（5.5%）（皮瓣存活率为95%）和伤口部位感染（5.5%）。患者的随访时间为26至38个月。观察到4例患者出现长期并发症即压疮复发（22%）。
LSAP皮瓣在文献中报道较少。我们认为，LSAP皮瓣是骶骨和坐骨缺损首选的皮瓣，其可在蒂部可靠掀起，手术时间短且手术并发症少。
