title: The fleur-de-lis upper gracilis flap for breast reconstruction: flap design and outcome.
abstract: We evaluated a fleur-de-lis design for the gracilis myocutaneous flap to improve flap volume for breast reconstruction. Thirty-one flaps were used in 17 consecutive patients undergoing the procedure for either thin body habitus (23 flaps) or prior abdominal surgery (8 flaps). The flap success rate was 100%. The fleur-de-lis flap provided proportionate breast reconstructions in all patients. Complications included 6 (19.3%) donor-site dehiscence and 4 (12.9%) episodes of cellulitis. Applying a negative pressure dressing to the donor site (n=26) significantly reduced the initially high dehiscence rate to 7.7% (P<0.01). There was no incidence of lower extremity edema or sensory loss. The fleur-de-lis gracilis flap can be performed with a low flap related complication rate and acceptable donor-site morbidity. Because of its standardized flap design, improved volume, and favorable breast shaping, it may allow autologous breast reconstruction to be offered to a greater number of patients.
authors.affiliation: Texas Center for Breast Reconstruction, Dallas, TX, USA.
authors.forename: Brice W
authors.initials: BW
authors.lastname: McKane
authors.forename: Peter T
authors.initials: PT
authors.lastname: Korn
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008866:Microsurgery; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D013848:Thigh