Wound Closure Using a Pedicled Superficial Inferior Epigastric Artery Flap for an Intractable Ischial Pressure Sore in a Patient with Spinal Cord Injury

Individuals with spinal cord injury spend considerable amounts of time in wheelchairs and are prone to recurrent ischial pressure sores.This report describes a case in which a recurrent ischial pressure sore was successfully reconstructed using a pedicle superficial inferior epigastric artery flap.The patient was a 59-year-old man who had sustained a spinal cord injury at the Th11 level in an accident at 37 years old and had been using a wheelchair ever since.After the injury, he engaged in sports and became a Paralympic powerlifter.At 48 years old, he developed a left ischial pressure sore, which was initially closed using a left posterior thigh flap.However, 11 years later, he developed recurrent ischial pressure sores in the same area.Considering the impact on his ability to participate in competitive powerlifting in the future, we reconstructed the ulcer using a pedicled superficial inferior epigastric artery flap, which is less invasive than the rectus abdominis muscle.The patient has been participating in normal social activities since the surgery.We believe that a pedicled superficial inferior epigastric artery flap is a practical second-line reconstruction option for recurrent ischial pressure ulcers.