The butterfly design: coverage of a large sacral defect with two pedicled lumbar artery perforator flaps

The treatment of sacral pressure sores in ambulatory patients presents a challenge to the reconstructive surgeon. We report the successful use of two pedicled lumbar artery perforator flaps to cover a sacral defect measuring 12cm×25cm. Stable coverage was provided, with protective sensibility, acceptable contour and minimal donor-site morbidity, while additional functional loss of the gluteal muscle was avoided. The configuration of the flaps resembles a butterfly.