Gracilis muscle flap for aesthetic reconstruction in the head and neck region

Abstract

Microsurgical tissue transfer has constantly improved the therapeutic options for reconstruction in the head and neck region, but the ideal flap has yet to be found. The purpose of this study is to discuss the aesthetic potential of the free gracilis muscle flap in difficult head and neck reconstruction. We report our experience with the free gracilis muscle flap in seven patients who underwent reconstruction in the head and neck region for a variety of indications. In all seven patients, the transplanted muscle flaps healed well, with no flap loss. Postoperative complications consisted of skin-graft loss in one patient requiring a second split-thickness skin graft. Donor-site morbidity was minimal in all patients. For difficult reconstruction in the head and neck region, the free gracilis muscle flap offers a number of advantages, including reliable vascular anatomy, relatively great plasticity, and a concealed donor area. Thus this type of flap offers a valuable option whenever an aesthetically pleasing result is sought.

The Transverse Musculocutaneous Gracilis Flap for Breast Reconstruction: Guidelines for Flap and Patient Selection

“…26 Since then, this muscle has been considered a workhorse in reconstructive microsurgery because of its reliable and constant anatomy, robust vascular pedicle, and ease of harvesting. [27][28][29] One often-overlooked attribute of this muscle flap is its well-hidden donor site, which can be further improved by harvest from a groin incision 30 or by endoscopic harvesting technique. 31 Only two groups reviewed the donor-site morbidity of this flap specifically, [32][33][34] but the skin island in their flaps was oriented longitudinally, which by far is inferior to the scar resulting from a transverse orientation.…”

Binocular single-refraction magnifying glasses for free flap surgery: a reliable method for developing countries

“…Eight different series were found in the literature working on gracilis free flap. Fattah et al [14], Kay et al [15], Huemer et al [16], Wechselberger et al [17], and Osiogo et al [18] had reported almost the same rate and type of complication working with the microscope. Del Frari et al [8] had reported slightly less complication rates, particularly partial flap necrosis.…”

The Quantified Human Gracilis-A Guide to Improve Aesthetic and Functional Outcomes

“…[3] In the same year Harii et al reported the first gracilis free flap for reconstruction of the head and neck and lower extremity. [4] Since the late seventies the gracilis myocutaneous flap has been used for soft tissue reconstruction of the breasts [5] , head and neck [6] , upper and lower extremity [7] and the genitoperineal region. [8] It has also been used as a free functioning muscle transfer for restoration of elbow flexion [9] , dynamic analplasty [10] and facial reanimation.…”