Partial muscle harvest: our first 100 cases attempting to preserve form and function at the donor site.
The authors report their first 100 partial muscle flaps as a strategy to preserve form and function of the donor site in muscle transplantation. Between 2003 and 2007, 62 partial superior latissimus (PSL) flaps and 38 partial medial rectus (PMR) flaps were transplanted for head and neck, upper and lower extremity, and chest wall reconstruction. All flaps survived. There were hematomas at the donor sites in two PMR cases. Form and function were preserved at the donor site in all cases. The PSL provided comparable muscle volume and pedicle length to the entire rectus abdominis muscle. An additional benefit was its use as a functional muscle. The PMR flap provided comparable muscle volume to the gracilis muscle. An additional benefit was a much longer vascular pedicle. Small to moderate sized flaps can be harvested from the fabric of the latissimus dorsi and rectus abdomenis muscles and be reliably transplanted. When positioned at the superior edge of the latissimus or medial edge of the rectus muscle, adequate blood flow and innervation to the residual muscle result in preservation of form and function at the donor site. The benefits of muscle transplantation can be realized without the associated morbidity of muscle harvest.
Department of Plastic and Reconstructive Surgery, Buncke Clinic, California Pacific Medical Center, San Francisco, CA, USA. darrellbrooks@usa.net
Darrell
D
Brooks
Rudolf F
RF
Buntic
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D010369:Pectoralis Muscles / Q000637:transplantation*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D020127:Recovery of Function; D017568:Rectus Abdominis / Q000098:blood supply / Q000637:transplantation*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply*; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014945:Wound Healing / Q000502:physiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000601:surgery; D055815:Young Adult