Reinnervated medial gastrocnemius free flap for closure of a recurrent ischial pressure sore: case report.
A 42-year-old T7 level paraplegic man had undergone multiple local flap transfers for closure of a recurrent left ischial pressure sore. When wound breakdown again occurred and regional flap transfers were no longer a possibility, a medial gastrocnemius free flap was transferred to the ischial region. Reinnervation of this flap was accomplished by interposing a sural nerve graft between a proximal intercostal nerve and the tibial motor nerve branch of the gastrocnemius muscle. Following the return of protective sensation, the patient has developed no new ischial pressure ulcerations.
Jones
Jonathan W
JW
D000058:Accidental Falls; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007512:Ischium; D008297:Male; D008866:Microsurgery / Q000379:methods; D018482:Muscle, Skeletal / Q000098:blood supply / Q000294:innervation / Q000637:transplantation; D010264:Paraplegia / Q000150:complications* / Q000175:diagnosis; D011312:Pressure; D003668:Pressure Ulcer / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D012720:Severity of Illness Index; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply* / Q000294:innervation*; D016896:Treatment Outcome; D014945:Wound Healing