Use of a gluteus musculocutaneous flap is the most reliable technique for surgical repair of sacral ulcers. Surgery could be ideally performed when the flap is designed using only the upper or the lower half of the glutens maximus muscle depending on the superior gluteal artery or the inferior gluteal artery, respectively. The authors have developed a technique for preoperative demonstration of the vascular supply to both muscle and overlying skin from a single gluteal artery using superselective catheterization and arterial administration of a dye (Patent Blue V). This technique facilitates the surgical procedure but assessment of its usefulness will require further evaluation.

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