[Flap coverage using the posterior gluteal thigh flap]

Defect coverage of the sacral, trochanteric or ischial region with durable tissue (gluteal thigh flap).

Decubital ulcers of the sacral, trochanteric or ischial region after exhaustion of conservative measures.

Moribund or palliative patients who do not benefit from defect coverage and are likely to suffer a life-threatening complication. Noncompliant patients, who cannot follow the postoperative recommendations or protocols in regard to positioning or recurrence prevention. The presence of extensive scars after previous operations in the donor area or irradiation of the donor area can lead to flap necrosis.

The posterior gluteal thigh flap can either be used as a fasciocutaneous flap or in combination with the gluteus muscle as myofasciocutaneous flap. Further microsurgical transfers have been described.

Following surgery the patient needs to be positioned on the side or prone to prevent recurrence. Drains should be left for 5-7 days. Antibiotics are only needed in the case of persistent florid infection.

The posterior gluteal thigh flap is a well-known, reliable and versatile option for coverage of decubital ulcers in the sacral and ischial region with low recurrence rates described in the literature.