Split gluteus maximus island flaps for concomitant closure of ischial and sacral pressure sores

The author presents an innovation in the use of the gluteus maximus musculocutaneous flap that allows one to repair both sacral and ischial pressure sores concomitantly in a paraplegic patient. The musculocutaneous unit is divided into superior and inferior halves, each of which is supplied by their respective gluteal arteries. The "islanded" flaps can be moved in different directions independent of one another to cover both the sacral and ischial regions at the same time. The donor area can be closed primarily. Three patients were operated using this method. The 1-year follow-up of 1 patient is presented.