Gluteus maximus rotation flap for pressure-induced injury

The patient presented with a stage IV pressure-induced injury over the sacrum (A). A gluteus maximus myocutaneous rotation flap was raised (B) and rotated into position to provide coverage (C). The appearance following healing is shown (D); however, a small area of recurrence can be seen at the distal incision. During healing and to manage the recurrence, the patient required the use of a temporary fecal diversion device.