Abstract: Objective　To investigate the feasibility of the perforator flap based on the first perforating branch of profunda femoral artery in reconstruction of patients with IV degree pressure ulcers in the region of buttock and thigh.　Methods　From January 2016 to February 2019, nine patients with IV degree pressure ulcers in the region of buttock and thigh were admitted to the department of Trauma and Orthopaedics, the Second people's Hospital of Xining city, including 3 males and 6 females, aged from 26~68 years, with an average age of 46 years. The causes of paraplegia were fall injury in 4 cases, traffic accident injury in 3 cases and cerebral infarction in 2 cases. After debridement, the wound area was 8 cm×5 cm~18 cm×9 cm. According to the shape, size and location of the wound, the perforator flap was designed to repair the pressure ulcers wound based on the first perforating branch of profunda femoral artery. The flap area was 10 cm×7 cm~20 cm×10 cm.　 Results　All flaps survived completely, including 2 cases with more local inflammatory exudates, and the flap recovered well after active conservative treating. 9 cases were followed up for 6 to 24 months, with an average of 13 months. The skin flap was good in color, soft in texture, and it did not affect daily life. No recurrence of pressure ulcers was found.　Conclusions　The perforator flap based on the first perforating branch of profunda femoral artery is easy to operate, reliable in blood supply and large amount of tissue supply. It is a better choice for the repair of patients with IV degree pressure sore in the region of buttock and thigh.

Key words: Profunda femoral artery, 　Perforator flap, 　Soft tissue defect, 　Pressure ulcers