Rectus abdominis flap closure of ischiosacral pressure sore.

An inferiorly based rectus abdominis musculocutaneous flap was used to close a large ischiosacral pressure sore refractory to the usual methods of closure in a paraplegic patient. The functions of the rectus abdominis muscle to initiate vertebral flexion from a supine position and aid in respiration, urination, defecation, and vomiting may play a proportionately greater role in the paraplegic patient. Although our patient did not experience any noticeable clinical deficits, this donor site is theoretically less functionally expendable in the paraplegic patient.