title: Secret scar free gracilis flap.
abstract: The gracilis free flap is a workhorse in plastic surgery. We present a modified technique that relies on a single horizontal thigh-lift-type approach, which (1) gives wide pedicle exposure, (2) provides material for skin grafting, and (3) allows for distal flap transection without an additional incision. Eighteen gracilis free flaps were performed from 2007 to 2009 for lower extremity reconstruction. Complete flap survival was observed in 17 patients with one partial necrosis distally. Our approach allowed access to divide the distal gracilis tendon without a second incision in all cases. The mean scar length was 16 ± 3 cm and no hypertrophic scars were observed. In 15 patients, no visible scar was observed in the upright position, and in three patients, the scar was visible dorsally (2 ± 1 cm). No sensory deficits were observed 6 months postoperatively. In addition, the split-thickness skin graft harvested from the skin paddle was sufficient to cover all defects.
authors.affiliation: Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland.
authors.forename: Mathias
authors.initials: M
authors.lastname: Tremp
authors.forename: Reto
authors.initials: R
authors.lastname: Wettstein
authors.forename: Wassim
authors.initials: W
authors.lastname: Raffoul
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Schaefer
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Kalbermatten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002921:Cicatrix / Q000517:prevention & control*; D004954:Esthetics; D058752:Free Tissue Flaps; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*