Purpose: Sacrectomy wound breakdowns following tumor resections present a subset of lumbrosacral wounds posing formidable reconstructive challenges. Free flap tissue transfer becomes a salvage procedure for these complex wounds. Cavitary defects, cerebrospinal fluid leaks, and exposed bone and neurovascular structures are associated with these lower back wounds. A paucity of recipient vessels and local tissue is common. These wounds are often recalcitrant to vacuum assisted closure (VAC) due to the exacerbation of radicular pain and cerebrospinal fluid leaks, when present. Methods: Free flap reconstruction in three patients with recalcitrant sacrectomy wounds was reviewed retrospectively. The patients were diagnosed with leiomyosarcoma, chordoma and osteogenic sarcoma of their sacrum’s respectively. Free flaps used were the latissimus dorsi muscle (two) and latissimus dorsi myocutaneous (one). Recipient vessels were the deep inferior epigastric vessels, posterior branches of the profunda femoris vessels and superficial femoral vessels. Results: Major complications involved loss of the cutaneous portion of the myocutaneous free flap and avulsion of the anastomotic repair of a free muscle flap. All flaps survived despite complications with healed wounds. Conclusions: These three cases illustrate the unique set of problems associated with post-oncologic sacrectomy wounds. Free tissue transfer is an effective measure to achieve primary healing.