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Updated: Nov 25, 2025

Engineered Vascularized Muscle Flap
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The modified bilobed flap for reconstructing sacral decubitus ulcers.

Xiangong Jiao1, Chunxiao Cui2,3,4, Sally Kiu-Huen Ng5

  • 1Plastic, Reconstructive and Burn Centre, Liuyang People's Hospital, 49 Renmin Middle Road, Liuyang 410300, Hunan, China.

Burns & Trauma
|December 18, 2020
PubMed
Summary

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This summary is machine-generated.

This study shows that a bilobed flap, supplied by the superior gluteal artery or fourth lumbar artery, is a reliable method for reconstructing sacral pressure ulcers in paraplegic patients.

Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Wound Management

Background:

  • Sacral pressure ulcers (stage III-IV) present significant morbidity and mortality risks.
  • Local flaps are common for reconstruction, but ideal flaps require simplicity, reliable vascularity, and minimal donor site issues.
  • This study investigates a bilobed flap technique for sacral pressure ulcer reconstruction.

Observation:

  • A retrospective analysis of 7 paraplegic patients (average age 53.1 years) treated between 2015-2019.
  • The bilobed flap was based on the superficial branch of the superior gluteal artery or the posterior branch of the fourth lumbar artery.
  • Average pressure ulcer size was 7x5 cm; all flaps survived with 12-month follow-up.

Findings:

  • The bilobed flap demonstrated reliable survival in all 7 cases.
Keywords:
Bilobed flapFourth lumbar arteryPressure soreSacrococcygealSuperior cluneal nerveSuperior gluteal artery

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  • No significant complications like flap necrosis or recurrence were observed.
  • The flap's vascular supply from the superior gluteal or fourth lumbar artery was confirmed.

    • Implications:

    • The bilobed flap technique is simple, reliable, and well-vascularized for sacral pressure ulcer reconstruction.
    • Inclusion of the superior cluneal nerve in the flap design is feasible.
    • This technique should be considered in the reconstructive algorithm for sacral pressure ulcers.