{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T05:56:39Z","timestamp":1768370199179,"version":"3.49.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T00:00:00Z","timestamp":1665100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sacral pressure ulcer reconstruction is frequently applied in plastic surgery practice. Although perforator flaps are frequently used, recurrence is not uncommon in patients. For this reason, using the as little area as possible during the reconstruction is vital. Therefore, we aimed to describe a mathematically standardized bilobed perforator flap design for sacral pressure ulcer reconstruction with a certain proportion and angle relation between limbs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 17 patients (5 female\/12 male)were included in this report. The mean age of the patients was 50.4\u2009years (Ranging from 32 to 79\u2009years). The patients with grade 3\u20134 sacral pressure ulcers were included in the report. The patients have grade 1\u20132 sacral ulcers or the other areas of pressure ulcer excluded. The size of the defects ranged from 8\u2009\u00d7\u200914\u2009cm to 5\u2009x\u200916\u2009cm. For ulcers in the sacral region, we used bilobed flaps that we mathematically standardized. The length of the first limb of the flap was planned 90\u00b0 vertically oriented according to the distance between the perforator zone to the distal lateral border of the defect. The width of the first limb was kept equal to the length of the defect. The orientation of the second limb of the flap was designed 90 degrees horizontally according to the first limb. Therefore, the lengths of second limbs were calculated as half of the first limb's width, and the widths of second limbs were calculated as \u00be width of the first limb's width.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 10 flaps were elevated based on superior gluteal artery perforators, and seven flaps were nourished by inferior gluteal artery perforators. The mean size of the first limb of the flaps was 14.7\u2009\u00d7\u20097.2\u00a0cm (Ranging from 8 to 20\u2009\u00d7\u20096 to 13\u2009cm). The mean size of the second limb of the flaps was 6.7\u2009\u00d7\u20095.3\u00a0cm (Ranging from 5 to 12\u2009\u00d7\u20094 to 8\u00a0cm). The mean size of defects was 10.5\u2009\u00d7\u20097.3\u00a0cm (Ranging from 8 to 14\u2009\u00d7\u20095 to 16). The mean rotation angle was 91.7\u00b0 (ranging from 90 to 100). In the early postoperative period, the hematoma was detected in three patients and evacuated in one patient, resulting in wound separation. Tip necrosis was seen in a patient that was healed by wound care. No total flap loss was encountered. No late\u2010term recurrence was seen during the follow\u2010up. The mean follow\u2010up time was 13.1\u00a0months (Ranging from 4 to 24\u2009months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Unilateral standardized bilobed perforator can reliably be preferred in medium to large size sacral pressure ulcer defects.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.30973","type":"journal-article","created":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T10:10:11Z","timestamp":1665137411000},"page":"229-237","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The use of mathematically standardized bilobed design perforator flaps for coverage of sacral pressure ulcers"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-8369","authenticated-orcid":false,"given":"Burak","family":"\u00d6zkan","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Baskent University  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2806-3006","authenticated-orcid":false,"given":"Abbas","family":"Albayati","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Baskent University  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5446-1940","authenticated-orcid":false,"given":"Burak Erg\u00fcn","family":"Tatar","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Bagc\u0131lar Training and Research Hospital University of Health Sciences  Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6236-0050","authenticated-orcid":false,"given":"Cagri Ahmet","family":"Uysal","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Baskent University  Ankara 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