We present a modified version of the gluteus maximus musculocutaneous flap for covering large lumbosacral defects. Emmett's hatchet flap (skin flap) is widely used for covering skin defects and with very good results. We prepare the gluteus maximus musculocutaneous flap by Emmett's method. Both muscle and skin are incised in a hatchet shape. The collateral blood supply between superior gluteal artery and inferior gluteal artery in the intact muscle bridge is not damaged. The skin and muscle bridge does not restrict the flap's mobility. The advantages of our method are: there is no need for a split skin graft; the donor area can be closed primarily; it provides a thick, heavy-duty, muscle-padded skin over the dural sac; the blood circulation of the flap is safe; the loss of one-half of the gluteus muscle causes no functional or esthetic disturbance.
- Gluteus maximus muscle
- Lumbosacral meningomyelocele
- Musculocutaneous hatchet flap
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