Abstract: Objective To investigate the effects of superior or inferior gluteal artery bilobed flap in repairing hip pressure ulcer in the elderly patients. Methods The clinical data of 21 elderly patients with stage 4 gluteal pressure ulcer admitted to our hospital from 2015 to 2021 were retrospectively analyzed. Among them, 13 cases were repaired with superior gluteal artery bilobed flap and 8 cases were repaired with inferior gluteal artery bilobed flap. The situations of blood supply and survival of the flap, wound healing and complications were observed. After discharge, the patients were followed up for the appearance of the hip donor and recipient areas and recurrence of the pressure ulcer. Results The wound area after debridement or extended resection ranged from 7.5 cm×6 cm to 12 cm×10 cm. All flaps survived with good blood supply and no incision dehiscence occurred. The flap healed by the first stage in 20 patients. One patient presented with a 2 cm× 2 cm wound on the flap 5 days after operation, and the local infection crept along the subcutaneous area. After debridement, dressing change and delayed suture, the flap healed by stage Ⅲ. All patients were followed up for 1 to 12 months. The appearance of the donor and recipient areas of the buttocks was smooth and there was no recurrence of pressure ulcer. Conclusions The superior gluteal artery or inferior gluteal artery double leaf flap can solve the problem of high tension in the donor area of single leaf flap, with reliable blood supply of the flap, less postoperative complications and well restored appearance of the donor area and the recipient area, which is especially suitable for repairing hip pressure ulcer in the elderly patients with atherosclerosis occlusion.

Key words: superior gluteal artery, inferior gluteal artery, bilobate flap, perforators flap, aged, pressure ulcers, repair