A Technique To Avoid a Dog-ear Deformity On the Buttock Using a "Pigeon Head" Modification of the Rotation Flap

Gluteal fasciocutaneous (FC) rotation flaps can still be used to close sacral pressure ulcers but tend to develop a large dog-ear on the buttock. This study presents a new method of avoiding a dog-ear deformity (Burow's triangle) while achieving adequate repair of pressure ulcers on the buttock by using a modification of the bilobed rotation flap. This "pigeon head" modification of the rotation flap successfully covered all 7 sacral ulcers. In all cases, Burow's triangles were unobtrusive immediately after surgery. This technique is simple, can be performed quickly, has minimal associated morbidity, and yields a good outcome.