BACKGROUND Sacral pressure ulcers are associated with high morbidity and, in some cases, result in mortality from severe sepsis. Local flaps are frequently used for reconstruction of stage III and IV pressure ulcers. An ideal flap should be simple to design, have a reliable vascular supply and minimal donor site morbidity. Our study evaluates the use of a bilobed flap based on the superficial branch of the superior gluteal artery or the posterior branch of the fourth lumbar artery to reconstruct the sacral pressure ulcer. CASE PRESENTATION We performed a retrospective analysis of paraplegic patients with sacral pressure ulcers treated with our bilobed flaps from January 2015 to December 2019. A description of our management, operative protocol, outcome and complications is outlined. Seven paraplegic patients (6 male, 1 female; average age 53.1 years) with sacral pressure ulcers were treated with our bilobed flap based on the superficial branch of the superior gluteal artery or the posterior branch of the fourth lumbar artery. The average size of the pressure ulcers was 7 × 5 cm (range 6.2 × 4.5 cm to 11 × 10 cm). All 7 flaps survived. The patients were followed up for 12 months without significant complications, such as flap necrosis or recurrence. CONCLUSIONS The superficial branch of the superior gluteal artery or the posterior branch of the fourth lumbar artery reliably supplies the bilobed flap. The superior cluneal nerve can be included in the design. The technique is simple and reliable. It should be included in the reconstructive algorithm for the management of sacral pressure ulcers.

中文翻译：

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改良双叶皮瓣重建骶褥疮溃疡。

背景技术骶骨压力性溃疡与高发病率相关，并且在某些情况下，导致严重败血症的死亡。局部皮瓣经常用于重建 III 期和 IV 期压疮。理想的皮瓣应该设计简单，血管供应可靠，供区发病率最低。我们的研究评估了使用基于臀上动脉浅支或腰第四动脉后支的双叶皮瓣重建骶骨压疮。病例介绍 我们对 2015 年 1 月至 2019 年 12 月使用我们的双叶皮瓣治疗的骶骨压疮截瘫患者进行了回顾性分析。概述了我们的管理、手术方案、结果和并发症。7 名截瘫患者（6 名男性，1 名女性；平均年龄 53 岁。1年）骶骨压力性溃疡采用我们的基于臀上动脉浅支或腰第四动脉后支的双叶皮瓣治疗。压疮的平均大小为 7 × 5 cm（范围 6.2 × 4.5 cm 至 11 × 10 cm）。所有 7 个皮瓣都幸存下来。患者随访 12 个月，无明显并发症，如皮瓣坏死或复发。结论臀上动脉浅支或腰第四动脉后支为双叶皮瓣供血可靠。膝上神经可包括在设计中。该技术简单可靠。它应该包含在骶骨压疮管理的重建算法中。