reatment of low-lying anorectal cancer and pelvic malignancies often involves neoadjuvant chemoradiation followed by abdominoperineal resection or pelvic exenteration. The resulting large soft-tissue defect can undergo primary closure or flap reconstruction. Even though the superiority of each method with regard to wound healing complications remains controversial in the literature, most studies demonstrate that attempts at primary closure following abdominoperineal resection are associated with high morbidity and complication rates. [1][2][3][4][5][6][7][8][9][10][11][12][13] Immediate flap reconstruction following abdominoperineal resection reduces the incidence of wound healing complications and fills dead-space created by tumor extirpation. 1,[4][5][6][7][8][9][10]12 More specifically, immediate flap reconstruction has been associated with lower rates of local