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J Reconstr Microsurg 2012; 28(05): 341-344
DOI: 10.1055/s-0032-1313765
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Secret Scar Free Gracilis Flap

Mathias Tremp
1   Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Basel, Basel, Switzerland
,
Reto Wettstein
1   Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Basel, Basel, Switzerland
,
Wassim Raffoul
2   Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, CHUV, University Hospital of Lausanne, Lausanne, Switzerland
,
Dirk J. Schaefer
1   Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Basel, Basel, Switzerland
,
Daniel F. Kalbermatten
1   Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, University Hospital Basel, Basel, Switzerland
2   Department of Plastic, Reconstructive, Aesthetic, and Hand Surgery, CHUV, University Hospital of Lausanne, Lausanne, Switzerland
› Author Affiliations
Further Information

Publication History

24 October 2011

13 January 2012

Publication Date:
15 May 2012 (online)

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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.

Keywords

free flap - scar - donor site morbidity
 

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