Electrical blanket was commonly used in Korea especially in winter season. Contact burn due to electrical blanket was increased in Korea and management of large soft tissue defects in the sacrum has been progressive developed. In this study, we report using the superior gluteal artery perforator flap with additional parasacral perforator supported by different angiosomes to cover large sacral defects due to 4th degree contact burn. 

A 79-year-old female with medical history of hypertension was referred for the treatment of 4th degree burns on the sacral area, caused by an electric blanket. After debridement, the sacral wound size was 11 x 10㎠. We subsequently planned the superior gluteal artery perforator super-flap with additional parasacral perforator because of the large defect size. The perforators were identified and mapped with a hand-held doppler. The flap was designed to include the superior gluteal perforator artery with the parasacral perforator artery. The flap size was 19x 16㎠ and the pedicle lengths of superior gluteal artery perforator and parasacral artery perforator were 4.5cm and 2cm respectively.

Dual perforator flap - Superior gluteal artery and parasacral perforator artery - was well covered the large sacral defect. Postoperative seroma was developed but resolved by conservative treatment.

The superior gluteal artery perforator super-flap with parasacral perforator with consideration of angiosome territories can be a good option in covering large sacral defect supposed to be unable to be covered by unilateral superior gluteal artery perforator artery flap. This procedure reduces the operation time and prevents unpredictable flap failure. Even though the parasacral perforator is included, versatility of the large superior gluteal artery perforator flap is preserved due to sufficient perforator length gained after adequate dissection.

Dual perforator flap for the Reconstruction of Large Sacral Defect due to Electrical blanket