title: A cause of severe sacral injury, sledding with a plastic bag: Case report.
abstract: BACKGROUND
  Various injuries are associated with winter sports, of which the most frequently encountered are traumas to the extremities. Sledding on hills using plastic-based materials appears to be one of the major forms of entertainment for children living in cities during winter. However, this can lead to injury because such areas are inappropriate for winter sports.
  
  
  METHODS
  We herein document a case of a 32-year-old male who presented to the emergency department following severe injury to the sacral region, caused by contact with a metal object while sledding with plastic bags. Patient had sacral defect including coccyx and sacral vertebrae and soft tissue. Primary closure, vacuum assisted closure and reconstruction with de-epithelized skin flap techniques were performed in 35 days period after injury.
  
  
  CONCLUSIONS
  Winter sports are associated with a wide variety of injuries, but tissue defects are rare. Seroma formation due to dead spaces can occur in traumas causing bony and soft tissue loss in sacral region as seen in our case. In order overcome this problem primary closure can be delayed or defect can be filled with a bulky flaps.
  
  
  CONCLUSIONS
  This case represents the first report of this particular combination of injury and treatment.
authors.affiliation: Bulent Ecevit University Medical Faculty Department of Plastic, Reconstructive and Aesthetic Surgery, A blok Kat:3 Kozlu-Zonguldak, Turkey. Electronic address: tahsinmd@gmail.com.
authors.forename: Tahsin
authors.initials: T
authors.lastname: Görgülü
authors.affiliation: Bulent Ecevit University Medical Faculty Department of Plastic, Reconstructive and Aesthetic Surgery, A blok Kat:3 Kozlu-Zonguldak, Turkey.
authors.forename: Merve
authors.initials: M
authors.lastname: Torun
keywords: De-epithelized flaps; Plastic bag; Sacral defect; Sacral injury; Skiing; Sledding