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.