Gluteal thigh flaps have been used to repair sacral and ischial pressure ulcers since first reported by Hurwitz in 1980. The major nutrient artery of the flap is a descending branch of the inferior gluteal artery, which makes close anastomosis with the obturator and medial circumflex femoral arteries, This anastomosis is called "Cruciate Anastomosis".In this article we report the successful use of a gluteal thigh flap incorporating cruciate anastomosis to repair ischial pressure ulcers. Between January 1997 and October 2003,we employed 6 gluteal thigh flaps incorporating cruciate anastomosis to repair 6 ischial pressure ulcers.All of the flaps survived and 3 of the pressure ulcers healed primarily, Wound dehiscen-ce was observed in 2 cases,but both of these cases were treated successfully by advancement of the original flaps, Pressure ulcer recurrence was observed in 1 case after the patient resumed riding a wheelchair.Gluteal thigh flaps incorporating cruciate anastomosis have a dual blood supply from both the internal iliac arterial and the external iliac arterial systems. This flap, therefore,has a reliable blood supply and offers surgeons a good reconstructive option for repairing ischial pressure ulcers.
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