{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:37:47Z","timestamp":1787063867365,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T00:00:00Z","timestamp":1719619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Perineal reconstruction after abdominoperineal excision often requires complex closures and is fraught with wound healing complications. Flap-based approaches introduce non-irradiated vascularized tissue to the area of resection to fill a large soft-tissue defect and dead space, reduce the risk of infection, and facilitate wound healing. Employing perforator flaps with their beneficial donor site properties, the authors have developed a concept of bilateral superior gluteal artery perforator (SGAP) flaps to restore extensive perineal defects. Methods: This retrospective case series was conducted between September 2015 and December 2019. We included three patients who received bilateral SGAP flap reconstruction after oncological resection. One deepithelialized SGAP flap was used for obliteration of dead space, combined with the contralateral SGAP flap for superficial defect reconstruction and wound closure. Results: Within this patient population, two male and one female patient, with a median age of 62 years (range, 52\u201376 years), were included. Six pedicled SGAP flaps were performed with average flap dimensions of 9 \u00d7 20 cm (range 7\u20139 \u00d7 19 \u00d7 21). No flap loss or no local recurrence were documented. In one case, partial tip necrosis with prolonged serous drainage was observed, which was managed by surgical debridement. No further complications were detected. Conclusions: The combination of two SGAP flaps provides maximal soft tissue for defect reconstruction and obliteration of dead space, while maintaining a very inconspicuous donor site, even with bilateral harvesting. Given these advantages, the authors recommend this promising approach for successful reconstruction of perineal defects.<\/jats:p>","DOI":"10.3390\/jcm13133825","type":"journal-article","created":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T09:06:07Z","timestamp":1719824767000},"page":"3825","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Bilateral Superior Gluteal Artery Perforator (SGAP) Flap: Modified Concept in Perineal Reconstruction"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4837-3896","authenticated-orcid":false,"given":"Maximilian","family":"Zaussinger","sequence":"first","affiliation":[{"name":"Section of Plastic and Reconstructive Surgery, Kepler University Hospital, Krankenhausstrasse 9, 4020 Linz, Austria"},{"name":"Medical Faculty, Johannes Kepler University Linz, Altenbergerstr. 69, 4040 Linz, Austria"},{"name":"Doctoral Degree Program in Medical Science, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8016-2216","authenticated-orcid":false,"given":"Gabriele","family":"Pommer","sequence":"additional","affiliation":[{"name":"Section of Plastic and Reconstructive Surgery, Kepler University Hospital, Krankenhausstrasse 9, 4020 Linz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7559-7147","authenticated-orcid":false,"given":"Katrin","family":"Freller","sequence":"additional","affiliation":[{"name":"Section of Plastic and Reconstructive Surgery, Kepler University Hospital, Krankenhausstrasse 9, 4020 Linz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8220-8419","authenticated-orcid":false,"given":"Manfred","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Section of Plastic and Reconstructive Surgery, Kepler University Hospital, Krankenhausstrasse 9, 4020 Linz, Austria"},{"name":"Medical Faculty, Johannes Kepler University Linz, Altenbergerstr. 69, 4040 Linz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg M.","family":"Huemer","sequence":"additional","affiliation":[{"name":"Medical Faculty, Johannes Kepler University Linz, Altenbergerstr. 69, 4040 Linz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"866e","DOI":"10.1097\/PRS.0000000000006158","article-title":"Comparison of Effective Cost and Complications after Abdominoperineal Resection: Primary Closure versus Flap Reconstruction","volume":"144","author":"Billig","year":"2019","journal-title":"Plast. 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