Anatomical study of the superior gluteal artery perforator (S-GAP) for free flap harvesting.

OBJECTIVE To present the appropriate superior gluteal branch for free flap harvesting. MATERIAL AND METHOD The characteristic and external diameter of the pedicles and the main perforators, and length of the pedicles were studied in both sides of 30 formalin-preserved cadavers. RESULTS The patterns of the pedicle could be classified into four types, the vertical, the horizontal, the descending, and the penetrating main branches. The descending branch was the longest (7.33 +/- 1.3 cm). While the pedicle and perforator of the horizontal branches was the largest (2.7 +/- 0.6 mm and 1.2 +/- 0.2 mm, respectively). However, it was difficult to dissect the vertical and the horizontal branches because the vessel courses did not run in the direction of the muscle fiber. Whereas the penetrating main branches were observed in the intermuscular septum so, it was easy to approach the pedicle. The length (5.3 +/- 1.3 cm) and external diameter (2.17 +/- 0.5 mm) of the pedicle were adequate for free flap harvesting. CONCLUSION In the anatomical study the penetrating pedicle was recommended to use for the S-GAP flap.