Area enlargement of the gracilis muscle flap through microscopically aided intramuscular dissection: ideas and innovations.
The gracilis muscle is one of the most extensively used muscles for free tissue transplantation. Its advantages are low donor-site morbidity with a concealed donor scar, a constant anatomy with large-diameter vessels, and the potential for a neurosensory flap as well as a large skin paddle. However, limitations comprise its limited size, and thus the muscle is limited to small-to-medium-sized defects. We present a novel technique by which the muscle can be enlarged 3-4 times over the regular muscle width. This can be achieved by microscopically aided intramuscular dissection of connective tissue with preservation of the intrinsic vessels of the muscle. With this technique, the field of application of the versatile gracilis muscle in reconstructive surgery can be further expanded.
Huemer
Georg M
GM
Department of Plastic and Reconstructive Surgery and Ludwig-Boltzmann Institute for Quality Control in Plastic and Reconstructive Surgery, Leopold-Franzens University, Anichstrasse 35, 6020 Innsbruck, Austria.
Dunst
Karin M
KM
Maurer
Herbert
H
Ninkovic
Milomir
M
D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D008408:Mastectomy / Q000379:methods; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D018570:Risk Assessment; D012888:Skull Neoplasms / Q000556:secondary / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*; D020858:Tissue and Organ Harvesting