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Transsacral usage of a pure island TRAM flap for a large sacral defect: a case report.

A pedicled transverse rectus abdominis musculocutaneous (TRAM) flap was used to reconstruct a large sacral defect retroperitoneally. Muscle and superiorly located skin were elevated on the deep inferior epigastric pedicle. The flap was transposed retroperitoneally from the abdominal wall to the sacral region of the patient. The selection criteria for this particular flap are discussed and compared with other reconstructive choices.