The inferior gluteal artery exits the greater sciatic foramen below the piriformis and supplies the inferior gluteus maximus and overlying skin. Its perforators for IGAP flap harvest emerge near the infragluteal fold, providing a donor scar hidden in the buttock crease. The flap provides similar volume to the SGAP but with a better concealed scar.
The IGAP (inferior gluteal artery perforator) flap provides gluteal fat and skin for breast reconstruction with the donor scar positioned in the infragluteal fold for excellent cosmesis. It requires perforator identification with pre-operative imaging. The sciatic nerve in the gluteal region must be protected throughout IGAP harvest as it exits the greater sciatic foramen close to the inferior gluteal artery. Sitting discomfort is a reported donor site morbidity from the infragluteal scar location.
The sciatic nerve exits the greater sciatic foramen immediately adjacent to the inferior gluteal artery, requiring identification and protection throughout IGAP flap elevation; inadvertent traction or thermal injury to the sciatic nerve produces foot drop and lower extremity sensory loss as a catastrophic donor site complication.
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